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Title

Prevention of vitamin K deficiency bleeding with three oral mixed micellar phylloquinone doses: results of a 6-year (2005-2011) surveillance in Switzerland
Authors
Laubscher, Bernard
Bänziger, Oskar
Schubiger, Gregor
CollaborationWith : Haenggeli, Charles-Antoine / Hüppi, Petra Susan / Posfay Barbe, Clara / Sizonenko, Stéphane / Tabin, René Roger
Published in European Journal of Pediatrics. 2013, vol. 172, no. 3, p. 357-60
Abstract In 2003, the Swiss guidelines to prevent vitamin K deficiency bleeding (VKDB) were adapted. As two oral doses (2 mg, hour/day 4) of mixed micellar VK preparation had failed to abolish late VKDB, a third dose (week 4) was introduced. This report summarizes the new guidelines acceptance by Swiss pediatricians and the results of a prospective 6-year surveillance to study their influence on the incidence of VKDB. The new guidelines acceptance by Swiss pediatricians was evaluated by a questionnaire sent to all pediatricians of the Swiss Society of Paediatrics. With the help of the Swiss Paediatric Surveillance Unit, the incidence of VKDB was monitored prospectively from July 1, 2005 until June 30, 2011. Over a 6-year period (458,184 live births), there was one case of early and four cases of late VKDB. Overall incidence was 1.09/10(5) (95 % confidence intervals (CI) 0.4-2.6). Late VKDB incidence was 0.87/10(5) (95 % CI 0.24-2.24). All four infants with late VKDB had an undiagnosed cholestasis at the time of bleeding; parents of 3/4 had refused VK prophylaxis, and in 1/4, the third VK dose had been forgotten. Compared with historical control who had received only two oral doses of mixed micellar VK (18 cases for 475,372 live births), the incidence of late VKDB was significantly lower with three oral doses (Chi(2),Yates correction, P = 0.007).
Keywords Administration, Oral — Antifibrinolytic Agents/administration & dosage/therapeutic use — Dose-Response Relationship, Drug — Drug Administration Schedule — Guideline Adherence/statistics & numerical data — Humans — Incidence — Infant — Infant, Newborn — Micelles — Physician's Practice Patterns/statistics & numerical data — Population Surveillance — Practice Guidelines as Topic — Prospective Studies — Questionnaires — Switzerland/epidemiology — Treatment Outcome — Vitamin K 1/administration & dosage/therapeutic use — Vitamin K Deficiency Bleeding/epidemiology/prevention & control
Identifiers
PMID: 23192459
Full text
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Structures
Faculté de médecine / Section de médecine clinique / Département de pédiatrie
Research groups L'imagerie cérébrale (184)
Groupe Posfay-Barbe Clara (pédiatrie générale) (853)
Citation
(ISO format) 		LAUBSCHER, Bernard, BÄNZIGER, Oskar, SCHUBIGER, Gregor. Prevention of vitamin K deficiency bleeding with three oral mixed micellar phylloquinone doses: results of a 6-year (2005-2011) surveillance in Switzerland. In: European Journal of Pediatrics, 2013, vol. 172, n° 3, p. 357-60. https://archive-ouverte.unige.ch/unige:41553

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Deposited on : 2014-11-05

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