Minimal platelet count for surgery in preterm infant

[Aedi Budi Dharma]

Greetings to all..

We have some issues that need clarification, at least in neonatology perspective. 

1. what is the minimal platelet count for surgery (e.g abdominal surgery) in preterm infant?

2. Do you routinely measure coagulation test before surgery? Especially in preterm infant?

3. Do we have evidence for this?

Thank you for your kind attention

[Stefan Johansson]

Hi there! The Stockholm practises (no written guidelines) are

1. ~100-ish

2. Depends, but if major surgery (like NEC) this is usually done as part of the workup

3. Not that I am aware of  

 

 

[rehman_naveed]

Yes we always measure. Just asking you a question that supposed these were not done and on table baby die due to bleeding, who to be blamed? Pre planned investigation and blood products arrangements are necessary. Not everything is evidence based, some common sense is also must. 
I hope this helps.

regards

[APiotrowski]

Yes we measure APTT, Platelets, Fibrinogen.

Minimal value for platelets would be 100 000 per ml.

Greetings !

[aalnemriksu]

We routinely check platelets and coagulation profiles for preterm infants  We do not feel comfortable to send baby to OR  with  platelets less than 100  

[Mo7]

Interesting topic, but I check this case report we published 🙂 

https://pubmed.ncbi.nlm.nih.gov/30413439/ 

[M C Fadous Khalife]

1- A platelet count of at least 100,000 per microliter is recommended. 50000 for minor interventions 

2- Yes we measure

3- Yes done by the American Societies of Anesthesiology and American Society of Hematology

and there is a recent article from 2020 published in the Lancet Hematology for immune hematology cases tolerating surgery at

less than 50000 platelets count anyway this must be evaluated case by case 

 

[piatkat]

Hi, 

I found this one paper: Platelet Transfusions in the Neonatal Intensive Care Unit https://www.sciencedirect.com/science/article/pii/S0095510815000391?via%3Dihub they address also requirements before surgery, but they acknowledge lacking data for preterm infants. The paper is from 2015.

While looking for something newer, I created a ResearchRabbit network of papers, you can check it out here: https://www.researchrabbitapp.com/collection/public/0LJWEY98ZW When you click "Later work", it will display papers which are connected with the papers mentioned in this thread  Maybe you will find something interesting. Good luck!

 

[Dr Jubara Alallah]

The minimal platelet count required for surgery in preterm infants varies depending on the individual infant's clinical status and the type of surgery planned. In general, a platelet count of at least 100,000/mm3 is considered safe for most surgical procedures in preterm infants. ( this is our practice in our institute )

However, it is important to note that the decision to proceed with surgery should be made on a case-by-case basis, taking into account the infant's clinical status, coagulation profile, and the risks and benefits of the procedure. Additionally, other factors such as the infant's gestational age, birth weight, and comorbidities may also impact the decision-making process