Platelet transfusions in adult ICU patients with thrombocytopenia: A sub-study of the PLOT-ICU inception cohort study Journal Article
| Authors: | Anthon, C. T.; Pène, F.; Perner, A.; Azoulay, E.; Puxty, K.; Van De Louw, A.; Chawla, S.; Castro, P.; Povoa, P.; Coelho, L.; Metaxa, V.; Kochanek, M.; Liebregts, T.; Kander, T.; Sivula, M.; Andreasen, J. B.; Nielsen, L. B.; Hvas, C. L.; Dufranc, E.; Canet, E.; Wright, C. J.; Schmidt, J.; Uhel, F.; Missri, L.; Krag, M.; Cos Badia, E.; Díaz-Lagares, C.; Menat, S.; Voiriot, G.; Erikstrup Clausen, N.; Lorentzen, K.; Kvåle, R.; Barratt-Due, A.; Hildebrandt, T.; Holten, A. R.; Strand, K.; Bestle, M. H.; Klepstad, P.; Vimpere, D.; Paulino, C.; Lueck, C.; Juhl, C. S.; Costa, C.; Bådstøløkken, P. M.; Lêdo, L. S. A.; Møller, M. H.; Russell, L. |
| Article Title: | Platelet transfusions in adult ICU patients with thrombocytopenia: A sub-study of the PLOT-ICU inception cohort study |
| Abstract: | 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. © 2024 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation. |
| Keywords: | adult; cancer chemotherapy; controlled study; aged; middle aged; major clinical study; clinical trial; drug megadose; antineoplastic agent; cohort studies; lung disease; thrombocytopenia; cohort analysis; hemoglobin; steroid; anticoagulant therapy; stem cell transplantation; intensive care; europe; intensive care unit; intensive care units; hematologic malignancy; heart failure; multicenter study; thromboembolism; comorbidity; hospital patient; immunosuppressive treatment; erythrocyte transfusion; therapy; critical care; chronic kidney failure; ischemic heart disease; immunosuppressive agent; antithrombocytic agent; thrombocyte transfusion; platelet count; anticoagulant agent; critical illness; descriptive research; cryoprecipitate; apheresis; clinical outcome; septic shock; fresh frozen plasma; international normalized ratio; thrombocyte concentrate; plasma transfusion; procedures; platelet transfusion; humans; human; male; female; article; solid malignant neoplasm; acute liver failure; pooled plasma (human); chronic liver failure |
| Journal Title: | Acta Anaesthesiologica Scandinavica |
| Volume: | 68 |
| Issue: | 8 |
| ISSN: | 0001-5172 |
| Publisher: | Acta Anaesthesiologica Scandinavica Fonden |
| Date Published: | 2024-09-01 |
| Start Page: | 1018 |
| End Page: | 1030 |
| Language: | English |
| DOI: | 10.1111/aas.14467 |
| PUBMED: | 38840310 |
| PROVIDER: | scopus |
| PMCID: | PMC11729610 |
| DOI/URL: | |
| Notes: | Source: Scopus |
