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

• DOI: 10.1007/s00431-019-03391-y
• Publication Date: 2019-05-06T16:32:55Z
• Authors: Yvette Nicole Löw...; Nicolaas Johannes...; Marc van Heerde; Richard Henryk Klein; Martin Christiaan...; Jan Willem Kuiper; Maaike Anne Riedijk; Carin Wilhelmus M...; Idse Hendrik Egbe...; Dirk Adriaan van ...; Peter Marin van H...
• Keywords: Regimen; Vitamin K deficiency

Vitamin K prophylaxis in infancy aims to prevent life-threatening vitamin deficiency bleeding (VKDB). The Dutch prophylactic oral daily regimen was increased sixfold from 25 150 μg because of a high failure rate. To evaluate the efficacy this new regimen, incidences intracranial VKDB under both regimens were compared using general and targeted surveillance. Late pediatric population identified by Netherlands Pediatric Surveillance Unit, between 1 October 2014 31 December 2016. Additionally, infants with Intensive Care Evaluation registry. incidence as assessed surveillance decreased 1.6 per 100,000 (95% CI, 0.4-5.1) 1.3 0.5-3.2) 3.1 live births 1.9-5.0) 1.2 0.6-2.3), respectively. Median time consecutive cases latter 24 154 days (p < 0.001).Conclusion: A increase associated surprisingly modest reduction VKDB, indicating that factors other than dose need addressing improve efficacy. What is Known: • intramuscular threatened an increasing number parents opting out. Oral represents attractive less invasive alternative but inferior, especially malabsorption due cholestasis. New: Increasing had effect on late bleeding. This finding indicates must play important role.