The challenge to define the optimal prophylactic regimen for vitamin K deficiency bleeding in infants

2020 ◽  
Author(s):  
Chiara Lembo ◽  
Giuseppe Buonocore ◽  
Serafina Perrone
Keyword(s):  
Vitamin K ◽  
Vitamin K Deficiency ◽  
Prophylactic Regimen ◽  
Vitamin K Deficiency Bleeding ◽  
K Deficiency

scholarly journals Belgian Consensus Recommendations to Prevent Vitamin K Deficiency Bleeding in the Term and Preterm Infant

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4109
Author(s):  
Simon Fiesack ◽  
Anne Smits ◽  
Maissa Rayyan ◽  
Karel Allegaert ◽  
Philippe Alliet ◽  
...  
Keyword(s):  
Vitamin K ◽  
Healthcare Providers ◽  
Vitamin K Deficiency ◽  
Oral Vitamin ◽  
Prophylactic Regimen ◽  
Vitamin K Deficiency Bleeding ◽  
Vitamin K Prophylaxis ◽  
Dosing Regimens ◽  
Parental Refusal ◽  
K Deficiency

Neonatal vitamin K prophylaxis is essential to prevent vitamin K deficiency bleeding (VKDB) with a clear benefit compared to placebo. Various routes (intramuscular (IM), oral, intravenous (IV)) and dosing regimens were explored. A literature review was conducted to compare vitamin K regimens on VKDB incidence. Simultaneously, information on practices was collected from Belgian pediatric and neonatal departments. Based on the review and these practices, a consensus was developed and voted on by all co-authors and heads of pediatric departments. Today, practices vary. In line with literature, the advised prophylactic regimen is 1 or 2 mg IM vitamin K once at birth. In the case of parental refusal, healthcare providers should inform parents of the slightly inferior alternative (2 mg oral vitamin K at birth, followed by 1 or 2 mg oral weekly for 3 months when breastfed). We recommend 1 mg IM in preterm <32 weeks, and the same alternative in the case of parental refusal. When IM is perceived impossible in preterm <32 weeks, 0.5 mg IV once is recommended, with a single additional IM 1 mg dose when IV lipids are discontinued. This recommendation is a step towards harmonizing vitamin K prophylaxis in all newborns.

scholarly journals Intracranial Hemorrhage Caused by Vitamin K Deficiency Beyond Neonatal Period

2017 ◽  
Vol 37 (1) ◽  
pp. 104-107 ◽  
Author(s):  
Sudhir Adhikari ◽  
Eva Gauchan ◽  
Tejesh Malla ◽  
Brijesh Sathian ◽  
Kalipatanam Seshagiri Rao
Keyword(s):  
Intracranial Hemorrhage ◽  
Vitamin K ◽  
Neonatal Period ◽  
National Policy ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Vitamin K Prophylaxis ◽  
Clinical Presentations ◽  
Intracranial Bleed ◽  
K Deficiency

Vitamin K deficiency bleeding (VKDB) can manifest as intracranial hemorrhage (ICH) and is still prevalent in poor resource countries. Infants aged one to twelve months with the diagnosis of ICH from 1st July 2011 to 30th June 2016 were included. There were 16 cases of ICH attributed to vitamin K deficiency. Clinical presentations were anemia16 (100%), bulged fontanel 13(81.3%), seizures 10(62.5%), vomiting 8(50%) and fever 9(56.3%). Mean INR at admission was 8.575±7.267 and 1.868±0.838 after three doses of vitamin K administration. Sites of intracranial bleed were parenchymal 5(31.3%), subdural 4(25%), extradural 2(12.5%), ventricular 2(12.5%). In 3(18.8%) of cases bleeding was more extensive involving more than one site. Mortality was 4(25%) and 3(18.8%) had abnormal neurological findings at discharge. There is an urgent need for national policy for vitamin K prophylaxis at birth.

scholarly journals Vitamin K prophylaxis for prevention of vitamin K deficiency bleeding: a systematic review

2016 ◽  
Vol 36 (S1) ◽  
pp. S29-S35 ◽  
Author(s):  
M J Sankar ◽  
A Chandrasekaran ◽  
P Kumar ◽  
A Thukral ◽  
R Agarwal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin K ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Vitamin K Prophylaxis ◽  
K Deficiency

scholarly journals Vitamin K Deficiency Bleeding in Infancy

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 780
Author(s):  
Shunsuke Araki ◽  
Akira Shirahata
Keyword(s):  
Oral Administration ◽  
Vitamin K ◽  
Placental Transfer ◽  
Late Onset ◽  
Newborn Infants ◽  
Coagulation Factors ◽  
Epidemiological Studies ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
K Deficiency

Vitamin K is essential for the synthesis of few coagulation factors. Infants can easily develop vitamin K deficiency owing to poor placental transfer, low vitamin K content in breast milk, and poor intestinal absorption due to immature gut flora and malabsorption. Vitamin K deficiency bleeding (VKDB) in infancy is classified according to the time of presentation: early (within 24 h), classic (within 1 week after birth), and late (between 2 week and 6 months of age). VKDB in infancy, particularly late-onset VKDB, can be life-threatening. Therefore, all infants, including newborn infants, should receive vitamin K prophylaxis. Exclusive breastfeeding and cholestasis are closely associated with this deficiency and result in late-onset VKDB. Intramuscular prophylactic injections reduce the incidence of early-onset, classic, and late-onset VKDB. However, the prophylaxis strategy has recently been inclined toward oral administration because it is easier, safer, and cheaper to administer than intramuscular injection. Several epidemiological studies have shown that vitamin K oral administration is effective in the prevention of VKDB in infancy; however, the success of oral prophylaxis depends on the protocol regimen and parent compliance. Further national surveillance and studies are warranted to reveal the optimal prophylaxis regimen in term and preterm infants.

Celiac disease with diffuse cutaneous vitamin K-deficiency bleeding

2007 ◽  
Vol 24 (6) ◽  
pp. 1286-1289 ◽  
Author(s):  
Zlatko Djuric ◽  
Sasa Zivic ◽  
Vuka Katic
Keyword(s):  
Celiac Disease ◽  
Vitamin K ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
K Deficiency
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