TY - JOUR

T1 - Platelet transfusions in adult ICU patients with thrombocytopenia

T2 - A sub-study of the PLOT-ICU inception cohort study

AU - Anthon, Carl Thomas

AU - Pène, Frédéric

AU - Perner, Anders

AU - Azoulay, Elie

AU - Puxty, Kathryn

AU - Van De Louw, Andry

AU - Chawla, Sanjay

AU - Castro, Pedro

AU - Povoa, Pedro

AU - Coelho, Luis

AU - Metaxa, Victoria

AU - Kochanek, Matthias

AU - Liebregts, Tobias

AU - Kander, Thomas

AU - Sivula, Mirka

AU - Andreasen, Jo Bønding

AU - Nielsen, Lene Bjerregaard

AU - Hvas, Christine Lodberg

AU - Dufranc, Etienne

AU - Canet, Emmanuel

AU - Wright, Christopher John

AU - Schmidt, Julien

AU - Uhel, Fabrice

AU - Missri, Louai

AU - Krag, Mette

AU - Cos Badia, Elisabet

AU - Díaz-Lagares, Cándido

AU - Menat, Sophie

AU - Voiriot, Guillaume

AU - Clausen, Niels Erikstrup

AU - Lorentzen, Kristian

AU - Kvåle, Reidar

AU - Barratt-Due, Andreas

AU - Hildebrandt, Thomas

AU - Holten, Aleksander Rygh

AU - Strand, Kristian

AU - Bestle, Morten Heiberg

AU - Klepstad, Pål

AU - Vimpere, Damien

AU - Costa, Carolina

AU - Lueck, Catherina

AU - Juhl, Christian Svendsen

AU - Costa, Carolina

AU - Bådstøløkken, Per Martin

AU - Lêdo, Lia Susana Aires

AU - Møller, Morten Hylander

AU - Russell, Lene

N1 - Publisher Copyright: © 2024 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

PY - 2024

Y1 - 2024

N2 - Background: Platelet transfusions are frequently used in the intensive care unit (ICU), but current practices including used product types, volumes, doses and effects are unknown. Study design and methods: Sub-study of the inception cohort study ‘Thrombocytopenia and Platelet Transfusions in the ICU (PLOT-ICU)’, including acutely admitted, adult ICU patients with thrombocytopenia (platelet count <150 × 109/L). The primary outcome was the number of patients receiving platelet transfusion in ICU by product type. Secondary outcomes included platelet transfusion details, platelet increments, bleeding, other transfusions and mortality. Results: Amongst 504 patients with thrombocytopenia from 43 hospitals in 10 countries in Europe and the United States, 20.8% received 565 platelet transfusions; 61.0% received pooled products, 21.9% received apheresis products and 17.1% received both with a median of 2 (interquartile range 1–4) days from admission to first transfusion. The median volume per transfusion was 253 mL (180–308 mL) and pooled products accounted for 59.1% of transfusions, however, this varied across countries. Most centres (73.8%) used fixed dosing (medians ranging from 2.0 to 3.5 × 1011 platelets/transfusion) whilst some (mainly in France) used weight-based dosing (ranging from 0.5 to 0.7 × 1011 platelets per 10 kg body weight). The median platelet count increment for a single prophylactic platelet transfusion was 2 (−1 to 8) × 109/L. Outcomes of patients with thrombocytopenia who did and did not receive platelet transfusions varied. Conclusions: Among acutely admitted, adult ICU patients with thrombocytopenia, 20.8% received platelet transfusions in ICU of whom most received pooled products, but considerable variation was observed in product type, volumes and doses across countries. Prophylactic platelet transfusions were associated with limited increases in platelet counts.

AB - Background: Platelet transfusions are frequently used in the intensive care unit (ICU), but current practices including used product types, volumes, doses and effects are unknown. Study design and methods: Sub-study of the inception cohort study ‘Thrombocytopenia and Platelet Transfusions in the ICU (PLOT-ICU)’, including acutely admitted, adult ICU patients with thrombocytopenia (platelet count <150 × 109/L). The primary outcome was the number of patients receiving platelet transfusion in ICU by product type. Secondary outcomes included platelet transfusion details, platelet increments, bleeding, other transfusions and mortality. Results: Amongst 504 patients with thrombocytopenia from 43 hospitals in 10 countries in Europe and the United States, 20.8% received 565 platelet transfusions; 61.0% received pooled products, 21.9% received apheresis products and 17.1% received both with a median of 2 (interquartile range 1–4) days from admission to first transfusion. The median volume per transfusion was 253 mL (180–308 mL) and pooled products accounted for 59.1% of transfusions, however, this varied across countries. Most centres (73.8%) used fixed dosing (medians ranging from 2.0 to 3.5 × 1011 platelets/transfusion) whilst some (mainly in France) used weight-based dosing (ranging from 0.5 to 0.7 × 1011 platelets per 10 kg body weight). The median platelet count increment for a single prophylactic platelet transfusion was 2 (−1 to 8) × 109/L. Outcomes of patients with thrombocytopenia who did and did not receive platelet transfusions varied. Conclusions: Among acutely admitted, adult ICU patients with thrombocytopenia, 20.8% received platelet transfusions in ICU of whom most received pooled products, but considerable variation was observed in product type, volumes and doses across countries. Prophylactic platelet transfusions were associated with limited increases in platelet counts.

KW - critical illness

KW - intensive care unit

KW - platelet transfusion

KW - thrombocytopenia

U2 - 10.1111/aas.14467

DO - 10.1111/aas.14467

M3 - Journal article

C2 - 38840310

AN - SCOPUS:85195428399

VL - 68

SP - 1018

EP - 1030

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 8

ER -