Selective prophylactic solvent-detergent plasma and cryoprecipitate transfusion to prevent intraventricular hemorrhage in extreme preterm infants: A case-historical control
Affiliations: [a]
King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Science, Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, Al-Ahsa, Saudi Arabia
| [b]
Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| [c]
Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
| [d]
Neonatology Division, Foothills Medical Center, University of Calgary, Calgary, Canada
Correspondence:
[*]
Address for correspondence: Dr. Sameer Al-Abdi, Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, PO Box 2477, Al-Ahsa 31982, Saudi Arabia. Tel.: +966135338079; Fax: +966 593333/Ext. 33844; E-mail: abdis@ngha.med.sa.
Abstract: BACKGROUND:Contradictory evidence exists whether a prophylactic coagulation factor transfusion in the first hours of life (HOL) prevents intraventricular hemorrhage (IVH) in extreme preterm infants (EPI, <28 weeks gestation). We aimed to determine whether selective prophylactic solvent-detergent plasma and cryoprecipitate transfusion within 12 hours of life (SP-SDP/Cryoprecipitate-T) could prevent IVH in EPI. METHOD:This is a retrospective analysis, case-historical control, of prospectively collected data from a pre-existing electronic neonatal database at a Saudi tertiary neonatal intensive care unit. We compared the IVH rate in EPI born in the first 4 years (Jan 2010–Dec 2013) of the SP-SDP/Cryoprecipitate-T period with that of EPI born during the last 4 years (Jan 2006–Dec 2009) of the rescue SDP/Cryoprecipitate-T period. RESULTS:The IVH rate was lower in the SP compared to the rescue- SDP/Cryoprecipitate-T period (30.8% versus 51.2%, odds ratio 0.42, 95% confidence interval 0.21, 0.88, p = 0.02). This difference remained significant after controlling for six other IVH risk factors. CONCLUSIONS:Early SP-SDP/Cryoprecipitate-T may reduce the IVH rate in EPI. A large multicenter clinical trial is required for confirm the short and long-term benefit and risk of this intervention. Until then, early SP-SDP/Cryoprecipitate-T may be considered by an institution with a persistently high IVH rate.
