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 Australian infants 1993–2017: an Australian Paediatric Surveillance Unit study

2019 ◽  
Vol 105 (5) ◽  
pp. 433-438 ◽  
Author(s):  
Yvonne Zurynski ◽  
Cameron J Grover ◽  
Bin Jalaludin ◽  
Elizabeth J Elliott
Keyword(s):  
Vitamin K ◽  
Home Delivery ◽  
Incidence Rates ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Live Births ◽  
Parental Refusal ◽  
K Deficiency ◽  
Surveillance Unit ◽  
Ongoing Surveillance

ObjectiveTo undertake surveillance of vitamin K deficiency bleeding (VKDB) in Australia from 1993 to 2017, during a time of change to national recommendations and available vitamin K formulations.MethodsPaediatricians reported cases of VKDB in infants aged <6 months and provided demographic, clinical and biochemical information via the Australian Paediatric Surveillance Unit.Results58 cases were reported, of which 5 (9%) were early, 11 (19%) classic and 42 (72%) late VKDB. 53 (91%) were exclusively breast fed. Seven (12%) received oral prophylaxis, the majority (86%) of whom did not receive all three recommended doses. The overall reported incidence was 0.84 per 100 000 live births (95% CI: 0.64 to 1.08) and the incidence of late VKDB was 0.61 per 100 000 live births (95% CI: 0.44 to 0.82), which are similar to rates reported by other countries where intramuscular vitamin K is recommended. VKDB rates were significantly higher (2.46 per 100 000 live births; 95% CI: 1.06 to 4.85) between 1993 and March 1994 when oral prophylaxis was recommended (p<0.05). Vitamin K was not given to 33 (57%) cases, primarily due to parental refusal, and the number of parental refusals increased significantly after 2006 (p<0.05). There were six deaths, all due to intracranial haemorrhage, and three associated with home delivery and parental refusal of vitamin K.ConclusionsIncidence rates of VKDB in Australia are among the lowest in the world; however, we have identified an increasing trend of parental refusal. Ongoing surveillance and educational campaigns for health professionals and parents are needed to prevent VKDB.

Vitamin K prophylaxis and late vitamin K deficiency bleeding in infants: Fifth nationwide survey in Japan

2011 ◽  
Vol 53 (6) ◽  
pp. 897-901 ◽  
Author(s):  
Daijiro Takahashi ◽  
Akira Shirahata ◽  
Susumu Itoh ◽  
Yukihiro Takahashi ◽  
Tomizo Nishiguchi ◽  
...  
Keyword(s):  
Vitamin K ◽  
Nationwide Survey ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Vitamin K Prophylaxis ◽  
K Deficiency

Vitamin K Deficiency Bleeding: An Ounce of Prevention

2020 ◽  
Vol 39 (6) ◽  
pp. 356-362
Author(s):  
Christopher McPherson
Keyword(s):  
Vitamin K ◽  
Health Care Professionals ◽  
Intramuscular Injection ◽  
Vitamin K Deficiency ◽  
Oral Vitamin ◽  
Vitamin K Deficiency Bleeding ◽  
Neonatal Pain ◽  
Single Intramuscular Injection ◽  
Clotting Cascade ◽  
K Deficiency

Vitamin K is a fat-soluble vitamin essential for the formation of factors in the clotting cascade. Newborns are born with insufficient levels of vitamin K, resulting in high risk for vitamin K deficiency bleeding (VKDB). Vitamin K deficiency bleeding can occur in the first week of life (“classic” VKDB) and also between 2 weeks and 3 months of age (“late” VKDB). Vitamin K deficiency bleeding can present as bleeding in the skin or gastrointestinal tract, with as many as half of affected neonates experiencing intracranial bleeding. A single intramuscular injection of vitamin K effectively prevents both classic and late VKDB. Although intramuscular vitamin K is safe and effective, VKDB has reemerged because of decreased utilization. Parents refuse intramuscular vitamin K for a variety of reasons, including a disproven association with childhood cancer, the desire to avoid exposure to additives, and valid concerns about early neonatal pain. Many parents request oral vitamin K, an inferior alternative strategy that requires multiple doses utilizing products not designed for neonatal oral administration. In this setting, health care professionals must understand the epidemiology of VKDB and compassionately counsel parents to assuage concerns. Delivery of intramuscular vitamin K to all newborns remains a public health imperative, benefitting thousands of infants annually.

scholarly journals INTRACEREBRAL BLEEDING IN LATE HEMORRHAGIC DISEASE OF THE NEWBORN

2019 ◽  
pp. 1-2
Author(s):  
Jayashree Nadkarni
Keyword(s):  
Vitamin K ◽  
Task Force ◽  
Current Status ◽  
Hemorrhagic Disease ◽  
Current Guideline ◽  
Vitamin K Deficiency ◽  
Vitamin K Deficiency Bleeding ◽  
Vitamin K Prophylaxis ◽  
New Born ◽  
K Deficiency

1 Vitamin K Ad Hoc Task Force. Controversies concerning vitamin K and the newborn. Pediatrics 1993; 91: 1001-1003. 2. Isarangkura PB, Pintadit P, Tejavej A, Siripoonya P. Chulajata C, Green GM. Vitamin K prophylaxis in the neonate by oral route and its significance in reducing infant mortality and morbidity. J Med Assoc Thai 1986; 69: 56-61. 3. Ijland MM, Pereira RR, Cornelissen EA. Incidence of late vitamin K deficiency bleeding in new-borns in the Netherlands in 2005: Evaluation of the current guideline. Eur J Paediatr 2008; 167: 165-169. 4. Waseem M. Vitamin K and hemorrhagic disease of new-borns. South Med J 2006; 99: 1199. 5. Lane PA, Hathaway WE. Vitamin K in infancy. J Pediatr 1985; 106: 351-359. 6. Singh M. Vitamin K during infancy: Current status and recommendations.Indian Pediatr 1997; 34: 708-712. 7. Bor O, Akgun N, Yakut A, et al. Late hemorrhagic disease of the new-born.Paediatr Int 2000; 42: 64-66. 8. D?Souza IE, Rao SD. Late hemorrhagic disease of new-born. Indian Paediatr 2003; 40: 226-229. 9. Flood VH, Galderisi FC, Lowas SR, et al. Hemorrhagic disease of the new-born despite vitamin K prophylaxis at birth. Paediatr Blood Cancer 2008; 50: 1075-1077. 10. Zengin E, Sarper N, Türker G, et al. Late haemorrhagic disease of the new- born. Ann Trop Paediatr 2006; 26: 225-231. 11. Sutor AH, Dagres N, Niederhoff H. Late form of vitamin K deficiency bleeding in Germany. KlinPediatr 1995; 207: 89-97

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