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Platelet transfusions in adult ICU patients with thrombocytopenia : A sub-study of the PLOT-ICU inception cohort study

Anthon, Carl Thomas ; Pène, Frédéric ; Perner, Anders ; Azoulay, Elie ; Puxty, Kathryn ; Van De Louw, Andry ; Chawla, Sanjay ; Castro, Pedro ; Povoa, Pedro and Coelho, Luis , et al. (2024) In Acta Anaesthesiologica Scandinavica
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 × 10 9/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... (More)

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 × 10 9/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 × 10 11 platelets/transfusion) whilst some (mainly in France) used weight-based dosing (ranging from 0.5 to 0.7 × 10 11 platelets per 10 kg body weight). The median platelet count increment for a single prophylactic platelet transfusion was 2 (-1 to 8) × 10 9/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.

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organization
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type
Contribution to journal
publication status
epub
subject
in
Acta Anaesthesiologica Scandinavica
publisher
Wiley-Blackwell
external identifiers
  • pmid:38840310
ISSN
0001-5172
DOI
10.1111/aas.14467
language
English
LU publication?
yes
additional info
© 2024 The Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.
id
2cef906b-c5b8-4e33-8987-d384bafac0c0
date added to LUP
2024-06-10 07:34:26
date last changed
2024-06-19 12:09:27
@article{2cef906b-c5b8-4e33-8987-d384bafac0c0,
  abstract     = {{<p>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.</p><p>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 &lt;150 × 10  9/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. </p><p>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 × 10 11 platelets/transfusion) whilst some (mainly in France) used weight-based dosing (ranging from 0.5 to 0.7 × 10 11 platelets per 10 kg body weight). The median platelet count increment for a single prophylactic platelet transfusion was 2 (-1 to 8) × 10 9/L. Outcomes of patients with thrombocytopenia who did and did not receive platelet transfusions varied. </p><p>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.</p>}},
  author       = {{Anthon, Carl Thomas and Pène, Frédéric and Perner, Anders and Azoulay, Elie and Puxty, Kathryn and Van De Louw, Andry and Chawla, Sanjay and Castro, Pedro and Povoa, Pedro and Coelho, Luis and Metaxa, Victoria and Kochanek, Matthias and Liebregts, Tobias and Kander, Thomas and Sivula, Mirka and Andreasen, Jo Bønding and Nielsen, Lene Bjerregaard and Hvas, Christine Lodberg and Dufranc, Etienne and Canet, Emmanuel and Wright, Christopher John and Schmidt, Julien and Uhel, Fabrice and Missri, Louai and Krag, Mette and Cos Badia, Elisabet and Díaz-Lagares, Cándido and Menat, Sophie and Voiriot, Guillaume and Erikstrup Clausen, Niels and Lorentzen, Kristian and Kvåle, Reidar and Barratt-Due, Andreas and Hildebrandt, Thomas and Holten, Aleksander Rygh and Strand, Kristian and Bestle, Morten Heiberg and Klepstad, Pål and Vimpere, Damien and Paulino, Carolina and Lueck, Catherina and Juhl, Christian Svendsen and Costa, Carolina and Bådstøløkken, Per Martin and Lêdo, Lia Susana Aires and Møller, Morten Hylander and Russell, Lene}},
  issn         = {{0001-5172}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Anaesthesiologica Scandinavica}},
  title        = {{Platelet transfusions in adult ICU patients with thrombocytopenia : A sub-study of the PLOT-ICU inception cohort study}},
  url          = {{http://dx.doi.org/10.1111/aas.14467}},
  doi          = {{10.1111/aas.14467}},
  year         = {{2024}},
}