2019
Increasing the dose of oral vitamin K prophylaxis and its effect on bleeding risk
Publication
Publication
European Journal of Pediatrics , Volume 178 - Issue 7 p. 1033- 1042
Abstract
Vitamin K prophylaxis in infancy aims to prevent life-threatening vitamin K deficiency bleeding (VKDB). The Dutch prophylactic oral daily regimen was increased sixfold from 25 to 150 μg because of a high failure rate. To evaluate the efficacy of this new regimen, incidences of intracranial VKDB under both regimens were compared using both general and targeted surveillance.
Late VKDB in the general pediatric population was identified by the Netherlands Pediatric Surveillance Unit, between 1 October
2014 and 31 December 2016. Additionally, infants with intracranial vitamin K deficiency bleeding were identified using the
Dutch Pediatric Intensive Care Evaluation registry. The incidence of intracranial VKDB as assessed by general and targeted
surveillance decreased from 1.6 per 100,000 (95% CI, 0.4–5.1) to 1.3 per 100,000 (95% CI, 0.5–3.2) and from 3.1 per 100,000
live births (95% CI, 1.9–5.0) to 1.2 per 100,000 live births (95% CI, 0.6–2.3), respectively. Median time between consecutive
cases in the latter increased from 24 to 154 days (p < 0.001).
Conclusion: A sixfold increase in oral vitamin K prophylaxis was associated with a surprisingly modest reduction in the incidence of intracranial VKDB, indicating that factors other than the dose need addressing to improve efficacy.
Additional Metadata | |
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doi.org/10.1007/s00431-019-03391-y, hdl.handle.net/1765/117867 | |
European Journal of Pediatrics | |
Organisation | Department of Gastroenterology & Hepatology |
Lowensteyn, Y.N., Jansen, N. J., van Heerde, M., Klein, R.H., Kneyber, M.C.J., Kuiper, J.-W., … van Hasselt, P. (2019). Increasing the dose of oral vitamin K prophylaxis and its effect on bleeding risk. European Journal of Pediatrics, 178(7), 1033–1042. doi:10.1007/s00431-019-03391-y |