What do platelets do? When are they low? (Thrombocytopenia in the Sick Newborn) - Tala Talks NICU
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- čas přidán 3. 05. 2020
- What is a platelet? What do they do? What causes the platelet number to fall?
Welcome to Tala Talks NICU. This video is about thrombocytopenia in the sick newborn. Please like and subscribe for additional topics to come!
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.
I’m so happy I found your fun and palatable lectures. Thank you to you and your team!
Thank you for watching and commenting Seyda. Love that adjective too: palatable! (What we're really striving for here!). Let us know if there's anything in particular you'd like us to record!
Absolutely vital videos for ANNP students !!!!!! Thank you
Fantastic! We’re so happy you feel that way- thanks for letting us know!!!! And good luck!!
Great lesson! So excited for Tala Talks NICU!
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Dr. Tala is such a great teacher! Excited about this CZcams channel!
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They are fascinating! Seriously addicted to your station. Intelligent and down to earth education. Thank you!!
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So happy to have found your channel! I am currently a pediatrics resident and aspire to become a neonatologist! Look forward to all your videos, Dr. Tala :)
We're so happy you found our channel!! You're picking the best specialty! Good luck!!
Such a great teacher! Awesome job!
Thank you Ashton!
Hi Dr Tala
Accidentally tapped on your presentation, now addicted to your marvellous presentations.
You certainly have a gift of gab. Simplifying the topic in am Impressive convincing way is your forte.
Stay blessed.
We're so happy Khalid that you found us and that you're enjoying watching! Thanks so much for your lovely compliment- I think I want to put alleged "gift of gab" on my resume! hahahah
I LOVE YOUR CHANNEL please make more videos .. you are literally making me more excited about NICU and I was just about to quit
Sasha- we've all been there!! Its tough after a few bad days in the NICU that drain you so much. But- those days also make us stronger, right?! We are so happy these are making you more excited about the NICU- we can't think of a better compliment! Thank you- and good luck!!
Thank you so much for doing this youtube-chanel! You explaning things so good. /NICU-nurse from Sweeden.
Hello Caroline! Thanks so much for your lovely words- they mean the world to us! Thank you for watching and for taking good care of the babies.
Very informative. Thank you Dr T
Thank you Vonny!
Dr. Tala, your videos are very educational and easy to understand. I' studying for my Nicu certification exam and your videos are the best!! Any video about DIC coming soon? Maybe in the future? Thanks for all you do!
Hello!!! So glad you find them helpful- thanks so much for taking the time to comment! We haven't directly discussed DIC yet- but maybe check out the coagulopathy video for now? But well get to that! Anything else you feel we're missing?!! Good luck in your exam !!!
I find this channel interesting because my mom is fighting tumor brain cancer. I like to do some research. Yes, I know what platelets is.
I'm so sorry about your mother- but also so impressed you're doing research. I wish her luck and health.
Good video
Thanks so much, Sumathy
Hi Dr. Tala! My husband (PICU Nurse) recommended your channel to me (NICU Nurse) so here I am! I found your topics interesting so I decided to start watching from the very beginning. After watching this video it gave me a good insight on platelets and I love how you explained it using an analogy. It also felt like I was sitting in class listening to a lecture. Keep it up! 😊❤
Hello BabyBecs!! We're so happy that was helpful.Especially since it was one of the first videos we filmed- and we still didn't really know what we were doing! (We've still got lots to learn about the whole youtube side of things but we're slowly getting there!) Thanks so much for taking the time to comment- and thank your husband too for directing you here! Hopefully it will continue to give you insight :)
Dr tala... Really very satisfied with ur videos..... Tysm for providing such informative videos.... Wanted to ask the reasons of thrombocytopenia even after transfusion
Hello Damini- I wrote a reply yesterday and lost it! Thank you for watching our videos!
Two main reasons for continued thrombocytopenia despite a transfusion:
1) The infant still has ongoing issues and has not started making platelets at a sufficient rate (e.g. with HIE or NEC).
2) The platelets are still being destroyed by a process that breaks down platelets (whether antibody mediated or not- e.g. NAIT or DIC).
Hope this helps!
@@TalaTalksNICU Tysm mam.... Really appreciated ur rply
we need causes in healthy babies ..thank you so much
YES! we need to get back to this! Will add to list! thank you!
Thanks
You're so welcome! You've watched them all now! we need to make some more for you!
@@TalaTalksNICU this make me happy
Last week I had sent you my mother's medical report. Hope you have look at it, if it is possible give me your opinions. Thank you!
I’m so sorry
Hi dr tala! What’s your take on the use of prophylactic antifungals for very sick preterm babies who are on antibiotics (ampicillin and gentamicin) for let say 3-5 days? Blood culture and urinalysis with hyphal elements are all unremarkable.
You have the best questions. My answer here would be dependent on the unit. Does the unit have a lot of fungal infections or not? If not, then it probably isn't necessary (especially if you're minimizing antibiotic usage and line days etc.) But if you've had a few candid infections, then prophylactic fluconazole a couple of times a week for all tiny babies has been shown to be effective.
I’ve read journals also on the use of prophylactic aminophylline for premmies
Aminophylline is a methylxanthine (just like caffeine). By the time I started residency even (2001), its use had fallen out of favor because it has such a narrow therapeutic index. As you now, we use caffeine now for apnea of prematurity. The amazing thing about caffeine is that it works in decreasing apnea, it decreases BPD- AND- it's one of the best studied drugs in the NICU-thanks to massive NICHD trials. So we know that if anything, the development of infants who received caffeine is better. (I love coffee too- so easy for me to understand...)
Thanks you for this useful video.but can you explain how can we diagnose alloimmune thrombocytopenia and when we expect it?
Hello! Great question! The funny thing is we don't really expect it. Normally a full term infant (most of the time) will have bruises or petechiae at birth and so we check a platelet count. Because NAIT is antibody mediated- and causes destruction, the platelets are normally really low, like < 20K. (This is different from say a PIH where platelets are normally >50K, and normally higher than this). Mother's platelet counts are normal (if they are low, you would suspect ITP). You can send the antigen type on the platelets - and confirm if it is HPA-1 positive (and the mother must have been negative). But most of the time we make a clinical diagnosis, based on an otherwise healthy child etc. Does this help?
@@TalaTalksNICU 👍
Thankyou very much.
@@TalaTalksNICU 👍
Thankyou very much.
Thankyou for this, it really helped me for an exam I have coming up. Could you please tell do a video on how these things lead to thrombocytopenia I'm struggling to find it anywhere. (Eg the mechanisms of how hypoxia leads to thrombocytopenia, or why babies that are IUGR have thrombocytopenia).
Thank you so much Rhiannon- and so glad it helps. Honestly I'm not sure of the exact mechanisms (specifically how the hormonal factors and proteins exert their effects)- but the way I always think about it is that the body will do what it can for its benefit. So in hypoxemia- (like with many placental insufficiency IUGR babies) the bone marrow will do whatever it can to preserve the HCT (likely at the expense of platelets). And in sepsis, the body needs RBCs and WBCs more than platelets- so again the bone marrow is diverted. Not sure how helpful this is!!!
@@TalaTalksNICU Thankyou for this 😊
Hi doc, have you heard about TORCH? My daughter's blood smear says that her thrombocytopenia occur because of an infection such as TORCH. That's why her doctor suggested to do TORCH PANEL TEST
Yes. TORCH infections are infections the mother can get, that can cross the placenta and cause more severe infections in fetuses. It stands for Toxoplasmosis, Other (e.g. syphilis/parvovirus), Rubella, CMV and Herpes. We will do a video on them soon. We hope your pregnancy goes as smoothly as possible.
Good day Dr Tala my baby was born at 34 weeks.my head water broke a day before he was born.they told me I had a infection at the neck of my womb.they gave me antibiotics for it then they gave me 2shots to delovop the baby lung I was supposed to get two more but the baby came before. When the baby gave they told me he drank some of the fluid while he was inside.they said he has a infection in is lung and he is breathing too fast he was on oxygen for one weeks on two day.now they are telling me is platelet are low he needs a platelet franfusion. What can I do I need your advice please.
Dear Nicola, we are sorry you are going through this. It sounds like your baby is having issues that many 34 week infants get, and that he is getting very good care. We wish your child health and luck, and you some peace XX
Dr. Tala. Yesterday I went to Hong Kong Sanatorium & Hospital and St. Paul's Hospital seeking their professional advise and doctors to attend the court of my mother. They said that they had no this service.
Maybe you need to find a doctor at the hospital your mother was at to go over chart with you. Wishing you luck
@@TalaTalksNICU Thank you Dr Tala. My mother had passed away on 22 June 2023.
May I send my mother's medical report for you to discover the cause of dead on tomorrow
@sklaw5857 I’m really sorry- but that’s just not something we can do. I am a neonatologist- I only take care of babies. I hope you find the help you want.
@@TalaTalksNICUDr. Tala, I understand that. I till hope I can send you a copy of my mother's medical report for your comment, and seeking your advice.
My girl is in South San Francisco, at Grand Ave. You can send her if you find not useful
Dr. Tala,
08 January 2024
Dear Madame,
Might I have your advice and assistance ?
I am Chinese and live in Hong Kong. My mother, Leung Ngan Hoi, was died 22 June 2023 in St. Teresa`s Hospital. She was murdered by three doctors ( Ms. Chan Kin Yin, Mr. Yeung Koon Sing and Mr. Lee Wah ). They did not cure my mother`s illness and intended to kill her with overdosing too much medicine, that made her had vasculitic and organs failure. By the way, they suppressesd her platelet counts down. On 6 June 2023 it was 297x10^9/Litre ( the first day in St. Teresa`s Hospital ) and fell to 23x10^9/litre on 18 June 2023. I found blood dots in her urine and tiny blood on her mouth. Dr. Lee Wah pretended not knowing why the falling of blood platelet.
Later they infused platelet to her and the platelet counts upto 66x10^9/litre on 19 June 2023. I thought the injection was not good to my mother, it might speedup the bloodclotting in body, and got pulmonary embolism. Especially she had also dosed Eliquis for a long time un-interrupted.
When she was dead, her lung had found pulmonary vascular congestion. In her medical report indicated that D-Dimer 1181 FEU ng/mL (
Thanks dr.i have the low.what food can i eat 2 make it better please
That is definitely a question for an adult doctor! We're just babies here!
@@TalaTalksNICU thanks dr god bless you
I had send you my mother's medical report a week ago at 2024 CZcams LLC, 901 Cherry Ave. San Bruno.
I wish you luck
@@TalaTalksNICU Thank you ! Dr. Tala has you recieved the document of my mother's report, I hope you can give expertised opinion that I can find out how my mother dead.
Thank you! Dr. Tala
❤
thank you :)
Is isolated thrombocytopenia s/o sepsis ?
Hello Sundeep- sorry this answer took a few days. It would be very unlikely that sepsis would present with only thrombocytopenia (without left shift, low ANC etc.), but in a sick looking kid, I would assume that the platelets fell before we are seeing any of the other abnormalities. Does this answer your question?
My newborn baby CRP level is 83 and platelets is 63000 pls advise
See below
Make video on NEC of neonate TIA #nainann
hello! Yes- We're covering NEC after the high frequency series. It's all coming- we promise! With full time jobs and a lot of kids between us, it takes time getting these videos out! Thank you for your patience :)
At what hour does platelets start to develop in newborn?
hello! platelets develop extremely early in the first trimester- so however young the baby is in the NICU, we would still expect them to have platelet counts > 150k. Hope that helps? Thanks for watching!
Noted doc thank you so much!! 🥰
Hi ,
Am from INDIA. My baby is 26 week 2Day premature.Now she is 29 week.she have sepsis and low platelets (45000) still not bleeding.Doctor did 3unit platelet transfusion. Is it danger? Please reply...
Congratulations on your baby- I'm sorry you have been going through these difficulties. It can take many days for platelets to come up when infants have sepsis. We wish you a smooth NICU course
@@TalaTalksNICU thank you. 3 days before 3rd time blood transfusion done . Still she is ok(platelet count 12 lakh). Is there any chance to low platelets ?
How to deal with low platelets in newborn specifically premature babies?
Hello Vangie! That's a great question- and nobody really knows. Generally if a baby is actively bleeding with low platelets (
@@TalaTalksNICU So it's okay for premies to drop their platelet count below 25k? The reason of me asking this is because my daughter was prematurely (28 weeks). Date of birth June 13,2021. She's still at the NICU fighting for sepsis and her body is really having a hard time producing platelets. Her recent cbc result showed 33k platelet count. She's taking antibacterial IVs and still not reaching the goal of at least 100k.
Hello! That study definitely lowered our thresholds. We used to give platelets at a higher value. But if there's no bleeding, then yes- we try to hold off to
Why do the platelets drop in babies with infection/stress?
That is an excellent question Britney! And I don't know the proteins/ enzymes/ hormones that are being shut off during stress- so instead I'll give you how I've always thought of it at a broader level. When an infant is 'stressed'- i.e. is having difficulty getting oxygen to their cells- whether that be from HIE or sepsis or PPHN, then that body goes into a state of wanting to make sure essential organs get all the oxygen they need (brain, heart). Less essential organs and functions shut down- and presumably the bone marrow is one of these (especially since platelets are redundant - we have way more than we need). So I always think of it as a non-essential step that the body does not need to do, while trying to heal as well and stay alive! Does this make sense?
@@TalaTalksNICU that makes perfect sense. Thank you!
Dear mam i am from india and immediately need your help to understand about my baby who is premature baby! Please say yes... I need your help
I'm sorry about your premature baby. What could we help you with?
@@TalaTalksNICU
Ma'am the baby is in NICU i have some medical reports of baby want to show you those reports!
The pletlates of the baby is falling down, doctors are doing transfusion, till now 15 ml of pletlates is given to the baby about 5 times!
We can't give you official medical advice, but please use email to send reports and we can take a look. I'm so sorry your family is going through this.
@@TalaTalksNICU thanks you so much for your kind help.... Please provide me official mail id so that i can send you reports urgently 🙏
Team tala thanks for your eagerness to help me! But sorry and feeling hurt to inform you i lost my baby! 🙏
It was impossible, she was died.
I’m sorry :(