Table 2
Guidelines for platelet transfusion thresholds for neonates
| Platelet count (×109/l) | Non-bleeding neonate | Bleeding neonate | Auto-ITP | NAITP (proven or suspected) |
|---|---|---|---|---|
| Auto-ITP, Autoimmune thrombocytopenia; NAITP, neonatal alloimmune thrombocytopenia; IVIG, intravenous immunoglobulin; BP, blood pressure; IVH, intravenous haemorrhage; HPA, human platelet antigen. | ||||
| <30 | Consider transfusion in all patients | Transfuse | Transfuse if bleeding present or IVIG unavailable | Transfuse (with HPA compatible platelets) if bleeding |
| 30–49 | Do not transfuse if clinically stable | Transfuse | Do not transfuse if stable and not bleeding | Transfuse (with HPA compatible platelets if bleeding present) |
| Consider transfusion if: | ||||
| <1000 g and <1 week of age | ||||
| Clinically unstable (eg fluctuating BP) | ||||
| Previous major bleeding tendency (eg grade 3–4 IVH) | ||||
| Current minor bleeding (eg petechiae, puncture site oozing) | ||||
| Concurrent coagulopathy | ||||
| Requires surgery or exchange transfusion | ||||
| 50–99 | Do not transfuse | Transfuse | Do not transfuse | Transfuse (with HPA compatible platelets if major bleeding present) |
| >99 | Do not transfuse | Do not transfuse | Do not transfuse | Do not transfuse |
