particularly platelets and fresh frozen plasma can also be
necessary, given particular clinical scenarios. In neonates,
thrombocytopenia is commonly associated with sepsis and counts
of <50,000 cells/mm^3 are associated^ with increased risk of
intracranial bleeding. Therefore, transfusion is recommended to
reach this target. In older children, platelet transfusion is indicated
for counts <10,000/mm^3 in absence of bleeding and <20,000/mm^3
in presence of bleeding.
Fresh frozen plasma should not be given to correct laboratory
values alone, as long as the patient responds to previously
discussed sepsis therapy. However, DIC and thrombotic purpura
are seen more frequently in pediatric population, and may progress
to purpura fulminans. FFP is indicated in these cases, as is
plasma exchange in centers that have such ability.- Consider adjuncts to conventional therapy
a) ECLS: Although heavily scrutinized in the adult population, both VV
and VA ECMO have been used successfully in support of pediatric