About this trial
The objective of the NeoPlaTT trial is to test whether, among extremely preterm infants born at 23 0/7 to 26 6/7 weeks' gestation, a lower platelet transfusion threshold, compared to a higher threshold, improves survival without major or severe bleeding up to 40 0/7 weeks' postmenstrual age (PMA).
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Gestational age of 23 0/7 to 26 6/7 weeks
Postnatal age of < 48 hours
Disqualifiers
Comfort care or withdrawal of care planned
Neonatal alloimmune thrombocytopenia or suspected/confirmed congenital platelet or bleeding disorder
Receipt of platelet transfusion
No receipt of Vitamin K
Trial design
Parallel
Treatments tested in this trial
Higher Platelet Transfusion Threshold
Procedure/SurgeryInfants randomized to this arm will be monitored for a platelet transfusion threshold of 50 x 10\^9/L during postnatal days 1-7, and then for a platelet transfusion threshold of 35 x 10\^9/L at 8 or more postnatal days of life. Infants will remain on this protocol-driven threshold through 40 0/7 weeks postmenstrual age. The platelet dose will be 10 ml/kg administered over 60-120 minutes.
Lower Platelet Transfusion Threshold
Procedure/SurgeryInfants randomized to this arm will be monitored for a platelet transfusion threshold of 25 x 10\^9/L during postnatal days 1-7, and then for a platelet transfusion threshold of 20 x 10\^9/L at 8 or more postnatal days of life. Infants will remain on this protocol-driven threshold through 40 0/7 weeks postmenstrual age. The platelet dose will be 10 ml/kg administered over 60-120 minutes.
Treatment groups
Trial outcomes
Primary outcomes
Survival without major or severe bleeding
Bleeding will be assessed using the neonatal Bleeding Assessment Tool (NeoBAT), a validated bleeding assessment tool (Venkatesh V, 2013)
Secondary outcomes
Death
Major or severe bleeding
Bleeding will be assessed using the neonatal Bleeding Assessment Tool (NeoBAT), a validated bleeding assessment tool (Venkatesh V, 2013)
Number of platelet transfusions
At least one platelet transfusion
Other outcomes
Late-onset sepsis
Necrotizing enterocolitis
Modified Bells Stage IIA or greater
Thrombosis requiring therapy
Thrombosis requiring therapy such as heparin, enoxaparin, or aspirin
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
NICHD Neonatal Research Network
Lead sponsor
National Heart, Lung, and Blood Institute (NHLBI)
Collaborator