An improvement project standardizing low prophylactic platelet transfusion dosing for infants.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-07-09 DOI:10.1038/s41372-025-02347-5

Kristen Coletti, Jennifer A Hershey, Matthew Devine, Jennifer Taft, Jeff Schinella, Sekinah Ajiboye, Kathleen Gibbs, Michele P Lambert, David Friedman, Christopher S Thom

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引用次数: 0

Abstract

Background: Platelet transfusions are frequently given to preterm infants to prevent bleeding, but randomized trials demonstrated harmful effects from current practices.

Problem: Many platelet transfusions were administered in 15-20 mL/kg doses.

Methods: We sought to decrease platelet exposure among neonates by standardizing 10 mL/kg transfusions for non-bleeding thrombocytopenic infants in a level IV NICU.

Interventions: We created evidence-based platelet dosing guidelines and changed practices in 3 plan-do-study-act cycles focused on education, reinforcement and electronic clinical decision support.

Results: We reviewed 240 transfusions over 3 years. The percentage of 10 mL/kg transfusions improved from 17.6% to 100%, without increasing major bleeding and repeat transfusion rates. Monthly transfused platelet volumes decreased from 2269 ± 334 mL to 857 ± 181 mL (p < 0.001), conserving limited platelet resources and saving $2746-$4942 per month in platelets.

Conclusions: This study improved our platelet transfusion practices and can facilitate similar transfusion guideline adoption to benefit neonates at other institutions.

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婴儿预防性血小板输注低剂量标准化改进项目。

背景：经常给早产儿输血小板以防止出血，但随机试验表明，目前的做法有害。问题：许多血小板输注的剂量为15- 20ml /kg。方法：我们试图通过对IV级NICU中无出血血小板减少的婴儿标准化10ml /kg输血来减少新生儿的血小板暴露。干预措施：我们创建了基于证据的血小板剂量指南，并在三个计划-研究-行动周期中改变了实践，重点是教育、强化和电子临床决策支持。结果：我们回顾了3年来240例输血。10 mL/kg输注的百分比从17.6%提高到100%，没有增加大出血和重复输注率。结论：本研究改善了我们的血小板输注实践，并可促进其他机构采用类似的输注指南，使新生儿受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.