Hemodynamics, fluids & transfusion
Prophylactic platelet transfusion response in critically ill patients: a prospective multicentre observational study
Authors' conclusion
In this study of critically ill patients, of whom more than half had bone marrow failure, almost three quarters of prophylactic platelet transfusions led to suboptimal platelet increment measured 18 to 24 h following platelet transfusion. Platelet storage duration was the only factor associated with poor platelet response that may be accessible to intervention.
Study context
- Population
- Critically ill patients receiving at least one prophylactic platelet transfusion in 9 ICUs472 transfusions
- Participants
- 181 patients
- Outcome
- Poor platelet transfusion response (corrected count increment (CCI) <7, adjusted for platelet dose and body surface area)
- Follow-up
- 18-24 h after platelet transfusion
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
Poor response, per transfusion: 349 of 472
73.9%
Poor response, per patient: 141/181
77.9%
Observational data: associations, not effects.
Further findings
Factors associated with platelet transfusion response (mixed-effect model)
| OR (95% CI) | ||
|---|---|---|
| Haemoglobin at ICU admissionPositively associated with response · independent associations | 0.79 (0.7–0.89) | |
| BMIPositively associated with response · independent associations | 0.93 (0.89–0.98) | |
| Haematological malignancyAssociated with suboptimal increment · independent associations | 1.93 (1.09–3.43) | |
| Sepsis as primary ICU admission diagnosisAssociated with suboptimal increment · independent associations | 2.81 (1.57–5.03) | |
| SOFA scoreAssociated with suboptimal increment · independent associations | 1.10 (1.03–1.17) | |
| Maximum platelet storage durationAssociated with suboptimal increment · independent associations | 1.24 (1.02–1.52) | |
| 0.20.5125Odds ratio (log scale) |
Clinical outcomes and RBC requirement, poor vs adequate response
- Did not differ between groups
Poor response in patients with haematology malignancy and chemotherapy (subgroup)
- Poor platelet transfusion response
- 93.5%
Original publication
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