Ree et al evaluated thrombocytopenia in neonatal sepsis and its implications. It can help to identify a neonate who may require more aggressive management. The authors are from Leiden University Medical Center, Academic Medical Center Amsterdam and Sanguin Blood Supply in The Netherlands.
Patient selection: neonatal sepsis
Thrombocytopenia was defined as a platelet count < 150 * 10^9/L
Severe thrombocytopenia was defined as a platelet count <= 50 * 10^9/L.
Risk factors for thrombocytopenia:
(1) maternal hypertension
(2) intravascular thrombosis (DIC, other)
(3) Gram-negative sepsis
(4) small for gestational age (SGA)
Complications of severe thrombocytopenia:
(1) severe intraventricular hemorrhage
(2) pulmonary hemorrhage
(3) increased risk of mortality
Risk factors for neonatal mortality on multivariate analysis:
(1) thrombocytopenia (platelet count < 150 * 10^9/L; OR 3.8)
(2) Gram-negative sepsis (OR 6)
