THROMBOCYTOPENIA AS ONE OF THE REASONS OF PROLONGED STAY IN THE NEONATAL INTENSIVE CARE UNIT
The aim of this paper was to present the occurrence and severity of thrombocytopenia, with intracranial and another bleeding in neonates with sepsis, analyze the risk factors for the development of thrombocytopenia and compare it with the length of hospitalization in the Neonatal Intensive Care Unit (NICU). Thrombocytopenia is a platelet count <150x109 / L and is common in newborns during hospitalization in the NICU. In the early days of life, the most common causes of thrombocytopenia in newborns are conditions that lead to fetal hypoxia, intrauterine growth failure, maternal hypertension, and sepsis. In this study were included all newborns with thrombocytopenia, who were hospitalized in NICU, Children's Disease Clinic, University Clinical Centre in Tuzla, from 01.01.2014 to 01.01.2019.
In our results, 379 newborns had severe, 337 moderate, and 127 milder forms of thrombocytopenia, without a statistically significant difference in the incidence of thrombocytopenia between groups of neonates born <37 GW and ≥ 37 GW. Sepsis was the most common cause of thrombocytopenia, 300 children had early sepsis and 190 late. We found the statistically significant difference in intracranial hemorrhage of the second degree and pulmonary hemorrhage among neonates born <37 GW in relation to newborns born ≥ 37GW. A statistically significant effect of length of stay of our neonates in the Department of Neonatal Intensive Therapy and morbidity was shown in relation to the lower gestational age and lower platelet counts.
Conclusion: Timely diagnosis of the cause and development of thrombocytopenia with adequate and effective treatment can reduce the mortality and morbidity of newborns with perinatal risk for neonatal thrombocytopenia.
Ree IMC, Fustolo-Gunnink SF, Bekker V, Fijnvandraat KJ, Steggerda SJ, Lopriore E. Thrombocytopenia in neonatal sepsis: Incidence, severity and risk factors. PLoS One. 2017;12(10):e0185581.
Roberts I, Stanworth S, Murray NA. Thrombocytopenia in the neonate. Blood Rev.2008; 22(4):173-86.
Murray NA, Howarth LJ, McCloy MP, Letsky EA, Roberts IA. Platelet transfusion in the management of severe thrombocytophenia in neonatal intensive care unit patients. Transfus Med. 2002;12(1):35-41.
Levit O, Bhandari V, Li FY, Shabanova V, Gallagher PG, Bizzarro MJ. Clinical and laboratory factors that predict death in very low birth weight infants presenting with late-onset sepsis. Pediatr Infect Dis J. 2014;33(2):143-6.
Sola- Visner M, Saxonhouse MA, Brown RE. Neonatal thrombocytopenia: what we do and do not know. Early Hum Dev. 2008;84(8):499-506.
Fustolo-Gunnink SF, Fijnvandraat K, Putter H, Ree IM, Caram-Deelder C, Andriessen P, et al. Dynamic prediction of bleeding risk in thrombocytopenic preterm neonates. Haematologica. 2019;104(11):2300-6.
Resch E, Hinkas O, Urlesberger B, Resch B. Neonatal thrombocytopenia- causes and outcomes following platelet transfusions. Eur J Pediatr. 20018; 177(7):1045-52.
Carr R, Kelly AM, Williamson LM. Neonatal thrombocytopenia and platelet transfusion – a UK perspective. Neonatology. 2015; 107(1):1-7.
Metha P, Vasa R, Neumann L, Karpatkin M. Thrombocytopenia in the high-risk infant. J Pediatr. 1980;97(5):791-4.
Baer VL, Lambert DK, Henry E, Christensen RD. Severe thrombocytopenia in the NICU. Pediatrics. 2009; 124(6):1095-100.
Christensen RD, Bear VL, Henry E, Snow GL, Butler A, Sola-Visner MC. Thrombocytopenia in small-for-gestation-age infants. Pediatrics.2015;136(2):361-70.
Ulsoy E, Tufekci O, Duman N, Kumral A, Irken G, Oren H. Thrombocytopenia in neonates: causes and outcomes. Ann Hematol. 2013;92(7):961-7.
von Lindern J, van de Bruele T, Loprioere E, Walther F. Thrombocytopenia in neonates and risk of intraventricular hemorrhage: a retrospective cohort study. BMC Pediatr.2011;11:16.
Ahmed F, Raj AY, Begum LN. Thrombocytopenia in late-onset neonatal sepsis and its relationship with the specific organism in a tertiary care hospital. Mymensingh Med J. 2017;26(4):900-5.
Saxonhouse MA, Manco-Johnson MJ. The evaluation and management of neonatal coagulation disorders. Semin Perinatol.2019;33(1):52-65.
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