Table 2

Guidelines for platelet transfusion thresholds for neonates

Platelet count (×109/l)Non-bleeding neonateBleeding neonateAuto-ITPNAITP (proven or suspected)
Auto-ITP, Autoimmune thrombocytopenia; NAITP, neonatal alloimmune thrombocytopenia; IVIG, intravenous immunoglobulin; BP, blood pressure; IVH, intravenous haemorrhage; HPA, human platelet antigen.
<30Consider transfusion in all patientsTransfuseTransfuse if bleeding present or IVIG unavailableTransfuse (with HPA compatible platelets) if bleeding
30–49Do not transfuse if clinically stableTransfuseDo not transfuse if stable and not bleedingTransfuse (with HPA compatible platelets if bleeding present)
Consider transfusion if:
    <1000 g and <1 week of age
    Clinically unstable (eg fluctuating BP)
    Previous major bleeding tendency (eg grade 3–4 IVH)
    Current minor bleeding (eg petechiae, puncture site oozing)
    Concurrent coagulopathy
    Requires surgery or exchange transfusion
50–99Do not transfuseTransfuseDo not transfuseTransfuse (with HPA compatible platelets if major bleeding present)
>99Do not transfuseDo not transfuseDo not transfuseDo not transfuse