University Publications
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Item Improvising neonatal thrombocytopenia management: Insights from split, volume-reduced, single-donor apheresis platelets (NeoVRs-SDAP)(Wiley, 2026) Dhiman, Yashaswi; Patra, Saikat et al.Introduction: Thrombocytopenia is common in neonates, managed with platelet transfusions at defined dose. The product type varies from neonatal-specific units using platelet additive solutions to adult products split into multiple paediatric units. In low-middle-income countries, whole blood-derived random donor platelets (RDP) are common while western countries use split adult single donor apheresis platelets (SDAP). We aimed to assess preliminary effectiveness of split, volume-reduced single donor apheresis platelets (NeoVRs-SDAP) in neonatal thrombocytopenia and observe early post-transfusion outcomes. Methods: Study was conducted from August 2024 to January 2025 at a tertiary healthcare centre. Persistent thrombocytopenic neonates admitted to the NICU were transfused with NeoVRs-SDAP prepared using Spectra Optia® with modified pro gram yielding an adult dose (300 109) in a reduced 100 mL of product volume. These were split into 2–5 aliquots for transfusion. Post-transfusion platelet incre ments and percentage recovery were assessed after 20–24 h. Results: Thirteen neonates' 77% preterm, 69.2% VLBW with sepsis received 46 NeoVRs-SDAP. 10 mL of this product contained nearly 3 times more platelets than RDP and 1.5 times more than adult SDAP of same volume. The mean transfused dose was 70.56 ± 14.21 109 platelets. Median platelet increment was 64 500/μL versus 15 477/μL for RDP (p < 0.001). Platelet recovery ranged from 7.5%–52.5%. Split products reduced donor exposure by 56.5%. Survival was 62%, without any transfusion-related adverse events. Conclusion: NeoVRs-SDAP may be potential alternative in persistent neonatal thrombocytopenia, offering better increments and recovery, reduced donor expo sure, and leukoreduction. Further RCTs comparing NeoVRs-SDAP and RDP are recommended.Item A pilot randomized controlled trial comparing noradrenaline and adrenaline as a first-line vasopressor for fluid-refractory septic shock in neonates(PUBMED, 2024-10-13) Reema Garegrat1 ,; Suprabha Patnaik; Sonali Suryawanshi; Chinmay Chetan; Nishant Banait; Pari Singh; Aditya Kallimath; Naharmal B. Soni; Yogen Singh; Pradeep SuryawanshiBackground and study design: Limited data exists on noradrenaline therapy in neonatal septic shock. We compared the efficacy of noradrenaline with adrenaline in neonatal septic shock. This single center, open label, pilot randomized controlled trial included neonates with clinical evidence of sepsis and shock. Study outcomes: Primary outcomes were: 1) resolution of shock one hour after treatment, and 2) mortality during hospital stay. Secondary outcomes included: need for additional vasopressors; hemodynamic stability without further administration of vasopressors for ≥2 h; changes in blood pressure and heart rate after 1 h of vasopressor treatment; and morbidities during the hospital stay. Results: Of 65 eligible neonates, 42 were randomized (21 each in adrenaline and noradrenaline treatment arms) between August 2020 and January 2022, at level III neonatal intensive care unit (NICU) of Bharati Vidyapeeth Deemed University Medical College and Hospital (BVDUMCH). The mean (SD) gestational age and mean (SD) birth weight were 36.1(4.2) weeks and 1.8 (0.2) kilograms birth weight for noradrenaline and 36.9 (4.1) weeks and 1.7 (0.7) kilograms for adrenaline. Shock resolved within 1 h of vasopressor therapy in 76.2% neonates in the noradrenaline arm and 61.9% in adrenaline arm (p value-0.53). Mortality during hospital stay was 28.6% (6/21) in noradrenaline group and 33.3% (7/21) in adrenaline group (p value- 0.58). Additional vasopressors were required in 23.8% neonates of the noradrenaline group compared to 38.1% neonates in adrenaline arm (p value-0.53). Median (SD) duration of intensive care stay was 6 (SD) days in the noradrenaline group and 10 (SD) days in the adrenaline group (p value-0.045). Conclusion: Among neonates with septic shock, the efficacy of noradrenaline was comparable to adrenaline in resolving septic shock after one hour of infusion and on the mortality during hospital stayItem Usefulness of Mean Gastric Emptying Time in Late Preterm and Term AGA and SGA Newborns to Determine Feeding Frequency—An Observational Study(SAGE Publications, 2023-06-14) Ankit Jain; Saikat Patra; Vinayak Madhukar Jedhe; Chinmay Chetan; Girish GuptaObjectives The primary objective is to calculate and compare mean gastric emptying time in appropriate for gestational age (AGA) and small for gestational age (SGA) newborns. The secondary objective is to compare mean gastric emptying time in SGA babies with or without antenatal Doppler changes and to measure gastric spheroidal volume at various intervals in AGA and SGA newborns with or without antenatal Doppler changes. Methods This prospective observational study was carried over 3 months from November 2022 to January 2023. A total of 30 newborns were enrolled and their gastric spheroidal volume was calculated by ultrasound pre-feed and post-feed every 30 minutes till it reached within 10% of pre-feed volume which was taken as gastric emptying time. Mean gastric emptying time was compared among AGA and SGA newborns and amongst SGA with or without antenatal Doppler changes. Results Mean gastric emptying time of AGA was 124 ± ± 25.01 minutes and for SGA was 132 ± 29.57 minutes which was statistically nonsignificant. Mean gastric emptying time when compared between SGA neonates with or without antenatal Doppler changes was similar (P value .43). The gastric spheroidal volume was significantly smaller in SGA newborns compared to their AGA counterparts in pre-feed state (P value .01) and it persisted till 60 minutes post feed (P value .028); however, the mean gastric emptying time is similar in both the groups. Conclusion Mean gastric emptying time of AGA and SGA newborns is similar and hence a feeding interval of 1.5 to 2.5 hours is appropriate for these late preterm and term newborns. Antenatal Doppler changes in SGA babies did not alter their gastric emptying time hence similar feeding frequency can be used in both.