Advances and Controversies in Neonatal ICU Platelet Transfusion Practice

Platelet transfusions are the principal means of treating thrombocytopenia in neonatal ICUs (NICUs). More than 95% percent of the platelet transfusions given to NICU patients are given prophylactically, with the supposition that this reduces the risk for a serious hemorrhage. Unfortunately, this common use of platelet transfusions in the NICU lacks a substantial evidence base. This review focuses on the issue of prophylactic platelet transfusion practice in the NICU and evaluates the rationale, benefits, risks, and the studies needed to improve this important aspect of neonatology practice.