Published online December 29, 2008
PEDIATRICS Vol. 123 No. 1 January 2009, pp. 278-285 (doi:10.1542/peds.2007-2850)

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Josephson, C. D. Articles by Sola-Visner, M. Search for Related Content PubMed PubMed Citation Articles by Josephson, C. D. Articles by Sola-Visner, M. Related Collections Blood Social Bookmarking                         What's this?

ARTICLE

Platelet Transfusion Practices Among Neonatologists in the United States and Canada: Results of a Survey

Cassandra D. Josephson, MD^a,b, Leon L. Su, MD^b, Robert D. Christensen, MD^c, Christopher D. Hillyer, MD^b, Marta-Inés Castillejo, BSN, MA^b, Michele R. Emory, BS^d, Yulia Lin, MD^e, Heather Hume, MD^e, Kirk Easley, MapStat^d, Brandon Poterjoy, DO^f and Martha Sola-Visner, MD^f

^a Aflac Cancer Center and Blood Disorders Services at Children's Healthcare of Atlanta, Atlanta, Georgia
^b Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
^c Intermountain Healthcare, Salt Lake City, Utah
^d Emory University School of Public Health, Atlanta, Georgia
^e Canadian Blood Services, Ottawa, Ontario, Canada
^f Drexel University College of Medicine, Philadelphia, Pennsylvania

OBJECTIVE. In the absence of scientific evidence, current neonatal platelet transfusion practices are based on physicians' preferences, expert advice, or consensus-driven recommendations. We hypothesized that there would be significant diversity in platelet transfusion triggers, product selection, and dosing among neonatologists in the United States and Canada.

METHODS. A Web-based survey on neonatal platelet transfusion practices was distributed to all members of the American Academy of Pediatrics Perinatal Section in the United States and to all physicians listed in the 2005 Canadian Neonatology Directory.

RESULTS. The overall response rate was 37% (1060 of 2875). In the United States, 37% (1007 of 2700) responded, of which 52% practiced at academic centers. Thirty percent (53 of 175) of Canadians responded, of whom 94% practiced at academic centers. As hypothesized, there was significant practice diversity in both countries. The survey also revealed that platelet transfusions are frequently administered to nonbleeding neonates with platelet counts of >50 x 10⁹/L. This practice is particularly prevalent among neonates with specific clinical conditions, including indomethacin treatment, preceding procedures, in the postoperative period, or with intraventricular hemorrhages.

CONCLUSIONS. There is great variability in platelet transfusion practices among US and Canadian neonatologists, suggesting clinical equipoise in many clinical scenarios. Prospective randomized clinical trials to generate evidence-based neonatal platelet transfusion guidelines are needed.

---

Key Words: platelet transfusions • neonates • transfusion-transmitted CMV • thrombocytopenia

Abbreviations: VLBW—very low birth weight • IVH—intraventricular hemorrhage • NEC—necrotizing enterocolitis • CMV—cytomegalovirus • TT-CMV—transfusion-transmitted cytomegalovirus

---

Accepted Apr 14, 2008.

CiteULike    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				S. J. Stanworth, P. Clarke, T. Watts, S. Ballard, L. Choo, T. Morris, M. F. Murphy, I. Roberts, and for the Platelets and Neonatal Transfusion Study G Prospective, Observational Study of Outcomes in Neonates With Severe Thrombocytopenia Pediatrics, November 1, 2009; 124(5): e826 - e834. [Abstract] [Full Text] [PDF]

				M. A. Saxonhouse and M. C. Sola-Visner Thrombocytopenia in the Neonatal Intensive Care Unit NeoReviews, September 1, 2009; 10(9): e435 - e445. [Abstract] [Full Text] [PDF]