TY - JOUR
T1 - Are thrombocytopenia and platelet transfusions associated with major bleeding in preterm neonates? A systematic review
AU - Fustolo-Gunnink, S. F.
AU - Huijssen-Huisman, E. J.
AU - van der Bom, J. G.
AU - van Hout, F. M. A.
AU - Makineli, S.
AU - Lopriore, E.
AU - Fijnvandraat, K.
PY - 2019/7
Y1 - 2019/7
N2 - Over 75% of severely thrombocytopenic preterm neonates receive platelet transfusions to prevent bleeding, but transfusion guidelines are based mainly on expert opinion. The aim of this review was to investigate whether platelet counts or transfusions are associated with major bleeding in preterm neonates. We performed a systematic search of the EMBASE and MEDLINE databases until December 2017. We included randomized trials, cohort and case control studies. (Prospero: CRD42015013399). We screened 8734 abstracts and 1225 fulltexts, identifying 36 eligible studies. In 30, timing of the platelet counts or transfusions in relation to the bleeding was unclear. Of the remaining six studies, two showed that thrombocytopenia was associated with increased risk of bleeding, two showed no such assocation, and three showed lack of an association between platelet transfusions and bleeding risk. The study results suggest that prophylactic platelet transfusions may not reduce bleeding risk in preterm neonates.
AB - Over 75% of severely thrombocytopenic preterm neonates receive platelet transfusions to prevent bleeding, but transfusion guidelines are based mainly on expert opinion. The aim of this review was to investigate whether platelet counts or transfusions are associated with major bleeding in preterm neonates. We performed a systematic search of the EMBASE and MEDLINE databases until December 2017. We included randomized trials, cohort and case control studies. (Prospero: CRD42015013399). We screened 8734 abstracts and 1225 fulltexts, identifying 36 eligible studies. In 30, timing of the platelet counts or transfusions in relation to the bleeding was unclear. Of the remaining six studies, two showed that thrombocytopenia was associated with increased risk of bleeding, two showed no such assocation, and three showed lack of an association between platelet transfusions and bleeding risk. The study results suggest that prophylactic platelet transfusions may not reduce bleeding risk in preterm neonates.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85054583833&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/30318111
U2 - https://doi.org/10.1016/j.blre.2018.10.001
DO - https://doi.org/10.1016/j.blre.2018.10.001
M3 - Article
C2 - 30318111
SN - 0268-960X
VL - 36
SP - 1
EP - 9
JO - Blood Reviews
JF - Blood Reviews
ER -