II. Pathophysiology

  1. Spontaneous endothelial bleeding does not occur until Platelet Count drops to less than 5000

III. Indications: Adults

  1. Platelet Count <100,000
    1. Ocular surgery (no active bleeding)
    2. Neurosurgery (no active bleeding)
  2. Platelet Count <50,000
    1. Major surgery
    2. Invasive procedure
  3. Platelet Count <20,000
    1. Fever (over 100.4 F) in an otherwise stable, non-bleeding patient
  4. Platelet Count <10,000
    1. Stable, non-bleeding patient

IV. Indications: Newborns

  1. Platelet Count 30,000 to 50,000
    1. Birth weight <1000 g and first week of life
    2. Cerebral Hemorrhage
    3. Coagulation disorder
    4. Sepsis
    5. Invasive procedure
    6. Alloimmune neonatal Thrombocytopenia
      1. Directed donation with washed and irradiated products
  2. Platelet Count 20,000 to 30,000
    1. Active bleeding
    2. Lumbar Puncture
  3. Platelet Count <20,000
    1. Stable, non-bleeding patient

V. Labs

  1. Platelet Count
    1. Adults: One apheresis unit (6 pack) increases platelets 30-60,000
    2. Newborns: 5-10 ml/kg increases platelets 50-100,000

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