School of Medicine, University College Dublin, Dublin, Ireland
Neonatology, National Maternity Hospital, Dublin, Ireland.
Arch Dis Child Fetal Neonatal Ed. 2023 Dec 15;109(1):70-73. doi: 10.1136/archdischild-2023-325632.
To assess the safety and feasibility of platelet transfusion through small-bore long lines used in the neonatal intensive care unit (NICU), including double-lumen umbilical venous catheters (UVCs) and 24 G and 28 G peripherally inserted central catheters (PICCs).
Prospective in vitro controlled study.
Blood transfusion service laboratory.
In vitro platelet transfusions were set up as per NICU practice. Transfusion line pressure was monitored. Post-transfusion swirling, presence of aggregates, pH analysis and automated cell count in vitro activation response by flow cytometry assessing CD62P expression were assessed.
All transfusions completed successfully. The rate of infusion was reduced in 5 of 16 transfusions through 28 G lines due to 'pressure high' alarms. There was no difference in swirling values or transfusion aggregate formation, CD62P expression levels, platelet count, platelet distribution width, mean platelet volume, plateletcrit or platelet to large cell ratio across transfusions post-transfusion.
This study showed that in vitro platelet transfusion performed through 24 G and 28 G neonatal PICC lines and double-lumen UVCs is non-inferior to 24 G short cannulas, using outcome measures of platelet clumping, platelet activation and line occlusion. This suggests that where available these lines can be used if necessary for platelet transfusion.
评估在新生儿重症监护病房（NICU）中使用小口径长管（包括双腔脐静脉导管（UVC）和 24G 和 28G 外周中心静脉导管（PICC））进行血小板输注的安全性和可行性。
前瞻性体外对照研究。
输血服务实验室。
根据 NICU 实践进行体外血小板输注。监测输血管路压力。评估输注后旋转、是否有聚集物、pH 值分析以及通过流式细胞术评估 CD62P 表达的自动细胞计数体外激活反应。
所有输血均成功完成。由于“压力高”警报，在 16 次输注中有 5 次通过 28G 管路的输注速度降低。输注后，旋转值或输血聚集物形成、CD62P 表达水平、血小板计数、血小板分布宽度、平均血小板体积、血小板比容或血小板与大细胞比无差异。
本研究表明，通过 24G 和 28G 新生儿 PICC 管路和双腔 UVC 进行体外血小板输注，在血小板聚集、血小板活化和管路堵塞等结果测量指标方面，与 24G 短管无差异。这表明，如果需要进行血小板输注，在有条件的情况下可以使用这些管路。
