Cardiothoracic & vascular anaesthesia

Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial

JAMAPublished Randomised controlled trial

Primary result · Chest drain bleedingResult — go to the resultRatio of geometric means 1.13 95% CI 0.96–1.34

Authors' conclusion

Cryopreserved platelets did not meet the predefined threshold for noninferiority in hemostatic effectiveness at 24 hours after ICU admission.

Study context

Population
Cardiac surgery patients at high risk of platelet transfusion, 11 Australian tertiary hospitals, 2021–2024202 transfused
Participants
388 patients
Comparison
Cryopreserved vs liquid-stored platelets
Primary endpoint
Postsurgical chest drain bleeding (non-inferiority: <20% greater bleeding)
Follow-up
First 24 hours after ICU admission
Methodological detailsmulticentre, double-blind, parallel-group, non-inferiority
  • Multicentre
  • Double-blind
  • Parallel-group
  • Non-inferiority

Primary result

Chest drain bleeding · 24 hours after ICU admission

Ratio of geometric means

1.13

95% CI 0.96–1.34

P = 0.07

By group

Cryopreserved vs Liquid-stored
ratio of geometric means 1.13 (95% CI 0.96–1.34); P = 0.07

Non-inferiority margin 20 as printed, not drawn

As reported in the abstract

Further findings

OutcomeRatio of geometric means (95% CI)
Intraoperative and total perioperative blood lossCryopreserved vs Liquid-stored · intraoperative1.42 (1.12–1.80)
Intraoperative and total perioperative blood lossCryopreserved vs Liquid-stored · total perioperative1.31 (1.07–1.60)

Intraoperative and total perioperative blood loss

Increased red cell, plasma and cryoprecipitate transfusion with cryopreserved platelets

Safety

OutcomeCryopreservedLiquid-stored
Duration of ventilation, ICU and hospital length of stayIQR in brackets
Ventilation25.5 hours [16.1-77.3]23.6 hours [13.1-52.8]
ICU stay3.8 days [2.0-6.0]3.0 days [1.9-4.9]
Hospital stay10.9 days [7.87-17.0]9.1 [6.9-14.9]

Prespecified adverse events

No differences in incidence of prespecified adverse events

Original publication

Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial. JAMA. Published 17 February 2026. doi:10.1001/jama.2025.23355

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