144 - Safety and Feasibility of Platelet Transfusion through Long Catheters in the Neonatal Intensive Care Unit

Saturday, April 29, 2023

3:30 PM – 6:00 PM ET

Poster Number: 144
Publication Number: 144.239

Carmel Maria Moore, National Maternity Hospital, Dublin, Dublin, Ireland; Sinead Brazil, Irish blood transfusion service, Dublin 08, Dublin, Ireland; Allison Waters, Irish Blood Transfusion Service, Dublin, Dublin, Ireland; Harry A. Croxon, Irish Blood Transfusion Service, Dublin, Dublin, Ireland; Anna Curley, National Maternity Hospital, Dublin, Dublin, Ireland

Presenting Author(s)

Carmel Maria Moore, MB BCh (she/her/hers)

Neonatologist and Research Fellow
National Maternity Hospital
Dublin, Dublin, Ireland

Background: Babies in the Neonatal Intensive Care Unit (NICU) often have central venous access in the form of umbilical venous catheters (UVC) and peripherally inserted central catheters (PICC). The PICCs used in the NICU population are commonly very small bore – 28G (1Fr) and 24G (2Fr). Babies who require platelet transfusions in the NICU are often very unwell, with difficult peripheral vascular access. The reported usage of UVC and PICC for platelet transfusion varies, and anecdotal concerns about line occlusion, platelet clumping and platelet activation were noted.

Objective: The primary objective of this study is to demonstrate feasibility and safety of transfusing platelets through long lines considering catheter blockage, inline pressure levels and platelet activation using CD62P

Design/Methods:

We performed the mock platelet transfusions as per our unit protocol. We compared 1Fr, 2Fr PICCs with a double 20G lumen UVC and a 24G standard PIVC. Donors gave informed consent. Platelets were processed as routine for neonatal-suitable transfusions. The volume and infusion rate was based on a 1000g neonate (15ml/kg over 30 minutes). Statistical analysis was completed using SPSS.

Results:

All 80 transfusions completed successfully. 5/16 transfusions through the 28G PICC line had their infusion rate reduced due to ‘Pressure High’ alarms. There was no difference in pre- and post-transfusion swirling values or aggregate formation.

Independent samples Kruskal Wallis test was used to determine if there were any significant differences in the post-transfusion parameters between groups. There was no difference across or between groups in post-transfusion CD62P levels.

Conclusion(s):

This study showed that in-vitro platelet transfusion through 24G and 28G neonatal PICC lines and double-lumen UVCs is non-inferior to 24G short cannulas, with no evidence of platelet clumping, platelet activation, or line occlusion. These results might be useful in practice, however safety of platelet transfusion through neonatal PICC lines remains to be confirmed in a prospective clinical study.