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Prevention of vitamin K deficiency bleeding with three oral mixed micellar phylloquinone doses: results of a 6-year (2005-2011) surveillance in Switzerland

Laubscher, Bernard
Bänziger, Oskar
Schubiger, Gregor
CollaborationWith : Haenggeli, Charles-Antoine / Hüppi, Petra Susan / Posfay Barbe, Klara / 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, OralAntifibrinolytic Agents/administration & dosage/therapeutic useDose-Response Relationship, DrugDrug Administration ScheduleGuideline Adherence/statistics & numerical dataHumansIncidenceInfantInfant, NewbornMicellesPhysician's Practice Patterns/statistics & numerical dataPopulation SurveillancePractice Guidelines as TopicProspective StudiesQuestionnairesSwitzerland/epidemiologyTreatment OutcomeVitamin K 1/administration & dosage/therapeutic useVitamin K Deficiency Bleeding/epidemiology/prevention & control
PMID: 23192459
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Research groups L'imagerie cérébrale (184)
Recherche en infectiologie pédiatrique et en pédiatrie générale (853)
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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. doi: 10.1007/s00431-012-1895-1 https://archive-ouverte.unige.ch/unige:41553

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Deposited on : 2014-11-05

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