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. 2023 Dec 15;109(1):70-73.
doi: 10.1136/archdischild-2023-325632.

Safety and feasibility of platelet transfusion through long catheters in the neonatal intensive care unit: an in vitro study

Carmel Maria Moore  1   2 , Alice Lorusso  3 , Liam Morgan  3 , Sinead Brazil  3 , Harry Croxon  3 , Allison Waters  3   4 , Aileen Farrelly  3 , Tor Hervig  3 , Anna Curley  5   2
Affiliations

Safety and feasibility of platelet transfusion through long catheters in the neonatal intensive care unit: an in vitro study

Carmel Maria Moore et al. Arch Dis Child Fetal Neonatal Ed. .

Abstract

Objective: 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).

Design: Prospective in vitro controlled study.

Setting: Blood transfusion service laboratory.

Methods: 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.

Main outcome measures: 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.

Conclusions: 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.

Keywords: Intensive Care Units, Neonatal; Neonatology; Technology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Set-up of laboratory transfusions using syringe pumps, lines and water bath.
Figure 2
Figure 2
Boxplot of maximum pressures in mm Hg reached during simulated transfusion across all groups. PICC, peripherally inserted central catheter; UVC, umbilical venous catheter; IVC, intravenous catheter.
Figure 3
Figure 3
Boxplot of CD62P expression levels (as a marker of platelet activation) across all groups. PICC, peripherally inserted central catheter; UVC, umbilical venous catheter; PIVC, peripheral intravenous catheter.
See this image and copyright information in PMC

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