Transfusions for preterm babies

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Science  30 Nov 2018:
Vol. 362, Issue 6418, pp. 1015-1016
DOI: 10.1126/science.362.6418.1015-d

Platelets are immune cell fragments that act like molecular band-aids to control bleeding and help blood to clot. Premature babies can have abnormally low platelet numbers (thrombocytopenia) in the days after birth and are often given platelet transfusions to help prevent infections. Curley et al. studied >600 babies in a randomized clinical trial to determine just how low platelets have to get to warrant intervention. Only those infants with severely low platelet levels (<25,000 per cubic millimeter; normal is around 150,000) benefited from transfusion. By contrast, thrombocytopenic babies with somewhat higher platelet counts (<50,000 per cubic millimeter) that received more transfusions had poorer outcomes and an increased rate of death. These surprising findings suggest that not all babies with low platelet counts should receive a prophylactic transfusion, which should lead to safer management of premature babies.

N. Engl. J. Med. 10.1056/NEJMoa1807320 (2018).

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