Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis

Objective:in order to conclude on the megakaryopoietic activity during thrombocytopenia in sepsis or necrotizing enterocolitis (nec), we analyzed the immature platelet fraction (ipf).study design:serial measurements of platelet counts and ipf in neonates with blood culture-proven late-onset sepsis (n=21) or surgical nec (n=12) at t0: prior to the diagnosis of sepsis/nec; t1: at diagnosis; t2: days 3 to 5 after onset; t3: days 8 to 12 after onset.result:in parallel to declining platelet counts, the median absolute ipf significantly decreased between t0 and t2 in neonates with sepsis or nec. we found a significant positive correlation between the platelet count and absolute ipf (r=0.71; p<0.001). in patients with low ipf (<2 per nl), the platelet count did not subsequently increase. neonates with nec who died exhibited significantly lower ipf compared with survivors (p<0.05).conclusion:low absolute ipf values during the course of neonatal sepsis/nec suggest suppression of megakaryopoietic activity.