Mean platelet volume vs. optical platelet volume measurement: which is a better indicator for neonatal sepsis?

Abstract Objectives To evaluate the accuracy of mean platelet volume (MPV) testing in the neonatal population and assess the applicability of the optical platelet volume measurement method on Sysmex XN9000 in this demographic. Methods From June 2023 to June 2024, we analyzed complete blood count (CBC) data from 1,070 neonates with infections to assess MPV testing reliability using instrument alerts and histograms. Additionally, 284 neonates without infections or hematologic diseases were included to evaluate the Sysmex optical platelet volume indicator (PLT-F-Y) reliability. Finally, four cases of neonatal sepsis were examined to determine the correlation between PLT-F-Y and neonatal sepsis. Results In neonates with infections, 24.67 % of MPV data did not accurately reflect platelet volume, and this issue was not confined to cases with low platelet counts. The PLT-F-Y indicator demonstrated superior accuracy in measuring platelet volume, with a reference range of approximately 42.6–64.2 mean fluorescence intensity (MFI) for neonates. Additionally, PLT-F-Y correlated with the progression of neonatal sepsis. Conclusions MPV is not a “perfect” indicator for newborns, whereas PLT-F-Y may serve as a potential better alternative.