Increasing the dose of oral vitamin K prophylaxis and its effect on bleeding risk

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 unde...

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Bibliographic Details
Published in:European journal of pediatrics 2019-07, Vol.178 (7), p.1033-1042
Main Authors: Löwensteyn, Yvette Nicole, Jansen, Nicolaas Johannes Georgius, van Heerde, Marc, Klein, Richard Henryk, Kneyber, Martin Christiaan Jacques, Kuiper, Jan Willem, Riedijk, Maaike Anne, Verlaat, Carin Wilhelmus Maria, Visser, Idse Hendrik Egbert, van Waardenburg, Dirk Adriaan, van Hasselt, Peter Marin
Format: Article
Language:English
Subjects:
Administration, Oral
Antifibrinolytic Agents - administration & dosage
Bleeding
Cholestasis
Cross-Sectional Studies
Dose-Response Relationship, Drug
Female
Humans
Incidence
Infant
Infant, Newborn
Infants
Intracranial Hemorrhages - epidemiology
Intracranial Hemorrhages - etiology
Intracranial Hemorrhages - prevention & control
Malabsorption
Male
Medicine
Medicine & Public Health
Netherlands - epidemiology
Original
Original Article
Pediatrics
Prophylaxis
Surveillance
Vitamin deficiency
Vitamin E
Vitamin K
Vitamin K - administration & dosage
Vitamin K Deficiency Bleeding - epidemiology
Vitamin K Deficiency Bleeding - prevention & control
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Summary: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  
ISSN:0340-6199
1432-1076
1432-1076
DOI:10.1007/s00431-019-03391-y