Transfusing neonates based on platelet count vs. platelet mass: a randomized feasibility-pilot study.

Abstract:

:The objective of this study was to obtain pilot data on which to judge the feasibility and sample size needed for a future comparative-effectiveness trial of platelet transfusions in the NICU. We conducted a limited-scope pilot trial in which neonates were randomized to receive platelet transfusions based on platelet mass vs. platelet count, using preset "transfusion-trigger" values. Analysis included parental consent rate, number of platelet transfusions given, bleeding episodes recorded, and mortality rate. Statistical analysis included ANOVA and Chi-square. A convenience sample of 30 were randomized; 15 per group. No differences were found between groups in gestational age, birth weight, race, gender or clinical diagnoses. The study consent rate was 52% (30/58). No differences were found in number of platelet transfusions received, bleeding episodes, or mortality. Lack of a trend in transfusion-reduction resulted in inability to estimate the number needed in a future comparative-effectiveness trial. Using platelet mass, rather than platelet count, for a NICU platelet transfusion trigger is feasible. However, any future comparative-effectiveness trial, testing the hypothesis that a platelet mass-based trigger reduces the transfusion rate will likely require a very large sample size.

journal_name

Platelets

journal_title

Platelets

authors

Zisk JL,Mackley A,Clearly G,Chang E,Christensen RD,Paul DA

doi

10.3109/09537104.2013.843072

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

513-6

issue

7

eissn

0953-7104

issn

1369-1635

journal_volume

25

pub_type

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