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Thrombocytopenia commonly occurs in neonates, often in association with sepsis or asphyxia. Prophylactic platelet transfusions are commonly considered when the platelet count is <50,000/μL, but whether a lower transfusion trigger would be equally effective is uncertain.
To examine this issue, investigators conducted a multicenter, randomized trial comparing
outcomes in 660 preterm infants given prophylactic platelet transfusions at platelet counts of either <50,000/μL or <25,000/μL.
The primary outcome of a composite of death or major bleeding up to day 28 occurred in more infants in the <50,000/μL group than in the <25,000/μL group (26% vs. 19%, P=0.02). Major bleeding was similar in the higher- and lower-threshold groups (14% and 11%, respec…