Key result
Intravenous vitamin K1 appears less effective than intramuscular administration against late-onset haemorrhagic disease.
Why the study?
Vitamin K deficiency bleeding is rare in low birthweight infants likely due to routine intramuscular vitamin K1, but the effectiveness of intravenous vitamin K1 for long-term prophylaxis is uncertain.
Does intravenous vitamin K1 prevent late onset haemorrhagic disease in premature infants?
Case Report (n=2)
Does intravenous vitamin K1 prevent late onset haemorrhagic disease in premature infants?
Intravenous vitamin K1 may be less effective than intramuscular administration for long-term prophylaxis against late onset haemorrhagic disease in premature infants.
Warrants caution against IV vitamin K1 in preterms; hypothesis-generating case report that leaves open optimal route.
The clinical details are reported of two premature infants who developed late onset haemorrhagic disease after receiving their initial doses of vitamin K1 prophylaxis intravenously. Both reported infants had received two doses of intravenous vitamin K1, 0.1 mg, in the 1st week of life, and a further oral dose, 1.0 mg, at 4 weeks. Bleeding due to vitamin K deficiency occurred on days 74 and 84, respectively. Vitamin K deficiency bleeding is rare in low birthweight infants, probably because it has been routine practice to give such infants intramuscular vitamin K1. One of the reported infants had cytomegalovirus hepatitis, the other did not have liver disease. These findings could be explained if intramuscular vitamin K1 were to have a longer duration of effect than intravenous vitamin K1. This may be because intramuscular vitamin K1 acts as a depot preparation. The findings suggest that intravenous vitamin K1 is less effective than intramuscular for long-term prophylaxis against late onset haemorrhagic disease. Intravenous vitamin K1 should not be used for long-term prophylaxis in the prevention of late onset haemorrhagic disease.
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Loughnan et al. (1996) conducted a case report in Late onset haemorrhagic disease (n=2). Intravenous vitamin K1 vs. Intramuscular vitamin K1 (routine practice) was evaluated on Late onset haemorrhagic disease. Two premature infants developed late-onset haemorrhagic disease on days 74 and 84 after receiving intravenous vitamin K1 prophylaxis, suggesting it is less effective than intramuscular administration.