2018CPS%uFF0FCFPC声明：新生儿维生素K预防指南.pdfVIP

P R A C T I C E Position Statement: Guidelines for vitamin K prophylaxis in newborns A joint statement of the Canadian Paediatric Society and the College of Family Physicians of Canada Eugene Ng MD Amanda D. Loewy MD Abstract Newborns are at risk for vitamin K defciency bleeding (VKDB) caused by inadequate prenatal storage and defciency of vitamin K in breast milk. Systematic review of evidence to date suggests that a single intramuscular (IM) injection of vitamin K at birth effectively prevents VKDB. Current scientifc data suggest that single or repeated doses of oral (PO) vitamin K are less effective than IM vitamin K in preventing VKDB. The Canadian Paediatric Society and the College of Family Physicians of Canada recommend routine IM administration of a single dose of vitamin K at 0.5 mg to 1.0 mg to all newborns. Administering PO vitamin K (2.0 mg at birth, repeated at 2 to 4 and 6 to 8 weeks of age) should be confned to newborns whose parents decline IM vitamin K. Health care providers should clarify with parents that newborns are at increased risk of VKDB if such a regimen is chosen. Current evidence is insuffcient to recommend routine intravenous vitamin K administration to preterm infants undergoing intensive care. Keywords HDNB; Newborn; Prophylaxis; Vitamin K; VKDB Background Switzerland), which suggested that administering vita- Hemorrhagic disease of the newborn (HDNB) was frst min K PO was less effective than by the IM route and identified over a century ago,1 and presents as unex- may be associated with higher incidence of failure.6 pected bleeding, often with gastrointestinal hemorrhage, Further, a 1993 review from the AAP Vitamin K Ad Hoc ecchymosis and, in many cases, intracranial hemor- Task Force effectively dispe