med 18

 

4. Platelets should not be infused through arterial lines.

Table 43.3 Guidelines for Platelet

Transfusion in Neonates

With Thrombocytopenia

1. Platelet count <30 × 109

/L in neonate with failure of platelet

production

2. Platelet count <50 × 109

/L in stable premature infant:

 With active bleeding

 Invasive procedure with failure of platelet production

 Extremely low-birthweight (<1,000 g) infants within the first week of

life

3. Platelet count <50 × 109

/L in neonates with (or presumed) NAIT*

4. Platelet count <100 × 109

/L in sick premature infant:

 With active bleeding

 Invasive procedure in patient with disseminated intravascular

coagulation

Without Thrombocytopenia

1. Active bleeding in association with qualitative platelet defect

2. Unexplained, excessive bleeding in a patient undergoing cardiopulmonary bypass

3. Patient undergoing extracorporeal membrane oxygenation:

 With a platelet count of <100 × 109

/L

 With higher platelet counts and bleeding

Adapted from Josephson CD. Neonatal and pediatric transfusion practice. In:

Roback JD, eds. Technical Manual of the American Association of Blood Banks. 16th

ed. Bethesda, MD: American Association of Blood Banks; 2008:639; Wong EC, Paul

WM. Intrauterine, neonatal, and pediatric transfusion therapy. In: Mintz PD, eds.

Transfusion Therapy: Clinical Principles and Practice. Bethesda, MD: American

Association of Blood Banks; 2011:209.

*NAIT, Neonatal Alloimmune Thrombocytopenia.