1.
Transfusing neonates based on platelet count vs. platelet mass: A randomized feasibility-pilot study
Zisk JL, Mackley A, Clearly G, Chang E, Christensen RD, Paul DA
Platelets. 2014;25((7):):513-6.
Abstract
Abstract The objective of this study was to obtain pilot data on which to judge the feasibility and sample size needed for a future comparative-effectiveness trial of platelet transfusions in the NICU. We conducted a limited-scope pilot trial in which neonates were randomized to receive platelet transfusions based on platelet mass vs. platelet count, using preset "transfusion-trigger" values. Analysis included parental consent rate, number of platelet transfusions given, bleeding episodes recorded, and mortality rate. Statistical analysis included ANOVA and Chi-square. A convenience sample of 30 were randomized; 15 per group. No differences were found between groups in gestational age, birth weight, race, gender or clinical diagnoses. The study consent rate was 52% (30/58). No differences were found in number of platelet transfusions received, bleeding episodes, or mortality. Lack of a trend in transfusion-reduction resulted in inability to estimate the number needed in a future comparative-effectiveness trial. Using platelet mass, rather than platelet count, for a NICU platelet transfusion trigger is feasible. However, any future comparative-effectiveness trial, testing the hypothesis that a platelet mass-based trigger reduces the transfusion rate will likely require a very large sample size.
2.
Recovery from deep-plane rhytidectomy following unilateral wound treatment with autologous platelet gel: a pilot study
Powell DM, Chang E, Farrior EH
Archives of Facial Plastic Surgery. 2001;3((4):):245-50.
Abstract
OBJECTIVE To determine the effects of treatment with autologous platelet-rich plasma mixed with thrombin and calcium chloride to form an autologous platelet gel (APG) on postoperative recovery from deep-plane rhytidectomy. STUDY DESIGN A prospective, randomized, controlled pilot study. SETTING An accredited ambulatory facial plastic surgery center. PATIENTS Healthy volunteer women (N = 8) undergoing rhytidectomy. INTERVENTION Unilateral autologous platelet-rich plasma wound treatment during standard deep-plane rhytidectomy. MAIN OUTCOME MEASURES Staged postoperative facial photographs were graded in a blinded fashion by 3 facial plastic surgeon reviewers for postoperative ecchymosis and edema. Each facial side treated with APG that demonstrated less edema or ecchymosis than the non-APG-treated side was designated a positive response; otherwise, the response was equal (no difference) or negative (untreated side had less edema or ecchymosis). RESULTS Twenty-one positive and 21 equal responses were observed compared with 8 negative ones. Of 20 unanimous observations, 15 were positive, only 3 equal, and 1 negative. CONCLUSIONS Treatment with APG may prevent or improve edema or ecchymosis after deep-plane rhytidectomy. This trend is more apparent for ecchymosis than for edema, and is chiefly demonstrable in the early phases of recovery. These observations are consistent with previous reports of cell tissue culture and wound response to concentrated platelet product.