Platelet transfusions in adult <scp>ICU</scp> patients with thrombocytopenia: A sub‐study of the <scp>PLOT</scp>‐<scp>ICU</scp> inception cohort study-Reference-Cited by-同舟云学术

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

Published:2024-06-05 Issue:8 Volume:68 Page:1018-1030
ISSN:0001-5172
Container-title:Acta Anaesthesiologica Scandinavica
language:en
Short-container-title:Acta Anaesthesiol Scand

Author:

Anthon Carl Thomas¹^ORCID,Pène Frédéric²^ORCID,Perner Anders¹³⁴^ORCID,Azoulay Elie⁴^ORCID,Puxty Kathryn⁵^ORCID,Van De Louw Andry⁶^ORCID,Chawla Sanjay⁷⁸^ORCID,Castro Pedro⁹^ORCID,Povoa Pedro¹⁰¹¹¹²^ORCID,Coelho Luis¹⁰¹¹^ORCID,Metaxa Victoria¹³^ORCID,Kochanek Matthias¹⁴^ORCID,Liebregts Tobias¹⁵,Kander Thomas¹⁶¹⁷^ORCID,Sivula Mirka¹⁸¹⁹^ORCID,Andreasen Jo Bønding²⁰^ORCID,Nielsen Lene Bjerregaard²¹,Hvas Christine Lodberg²²^ORCID,Dufranc Etienne²³^ORCID,Canet Emmanuel²⁴^ORCID,Wright Christopher John²⁵^ORCID,Schmidt Julien²⁶^ORCID,Uhel Fabrice²⁷²⁸^ORCID,Missri Louai²⁹,Krag Mette³³⁰^ORCID,Cos Badia Elisabet³¹^ORCID,Díaz‐Lagares Cándido³²³³^ORCID,Menat Sophie³⁴,Voiriot Guillaume³⁵^ORCID,Erikstrup Clausen Niels³⁶^ORCID,Lorentzen Kristian³⁷^ORCID,Kvåle Reidar³⁸³⁹^ORCID,Barratt‐Due Andreas⁴⁰^ORCID,Hildebrandt Thomas⁴¹^ORCID,Holten Aleksander Rygh⁴²⁴³^ORCID,Strand Kristian⁴⁴^ORCID,Bestle Morten Heiberg³⁴⁵^ORCID,Klepstad Pål⁴⁶⁴⁷^ORCID,Vimpere Damien⁴⁸,Paulino Carolina⁴⁹^ORCID,Lueck Catherina⁵⁰^ORCID,Juhl Christian Svendsen⁵¹^ORCID,Costa Carolina⁵²,Bådstøløkken Per Martin⁵³,Lêdo Lia Susana Aires⁵⁴^ORCID,Møller Morten Hylander¹³^ORCID,Russell Lene¹³⁴^ORCID

Affiliation:

1. Department of Intensive Care Copenhagen University Hospital – Rigshospitalet Copenhagen Denmark

2. Médecine Intensive & Réanimation, Hôpital Cochin, Assistance Publique – Hôpitaux de Paris Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité Paris France

3. Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

4. Médecine Intensive & Réanimation, Hôpital Saint‐Louis, Assistance Publique – Hôpitaux de Paris Université Paris Cité Paris France

5. Department of Intensive Care Glasgow Royal Infirmary Glasgow UK

6. Division of Pulmonary and Critical Care Penn State University College of Medicine Hershey Pennsylvania USA

7. Critical Care Medicine Service, Department of Anesthesiology & Critical Care Medicine Memorial Sloan Kettering Cancer Center New York New York USA

8. Department of Anesthesiology Weill Cornell Medical College New York New York USA

9. Medical Intensive Care Unit, Hospital Clinic of Barcelona; IDIBAPS University of Barcelona Barcelona Spain

10. Department of Intensive Care Sao Francisco Xavier Hospital, CHLO Lisbon Portugal

11. Nova Medical School CHRC, New University of Lisbon Lisbon Portugal

12. Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology Odense University Hospital Odense Denmark

13. Department of Critical Care King's College Hospital NHS Foundation Trust London UK

14. Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany

15. Department of Hematology and Stem Cell Transplantation University Hospital Essen, University of Duisburg‐Essen Essen Germany

16. Department of Intensive and Perioperative Care Skåne University Hospital Lund Sweden

17. Department of Clinical Sciences Lund University Lund Sweden

18. Department of Perioperative and Intensive Care Medicine University of Helsinki and Helsinki University Hospital Helsinki Finland

19. Coagulation Disorders Unit, Department of Hematology University of Helsinki and Helsinki University Hospital Helsinki Finland

20. Department of Anaesthesia and Intensive Care Aalborg University Hospital Aalborg Denmark

21. Department of Anaesthesiology and Intensive Care Odense University Hospital Odense Denmark

22. Department of Anaesthesiology and Intensive Care Aarhus University Hospital Aarhus Denmark

23. Service de Médecine Intensive Réanimation Hôpitaux Universitaires Henri‐Mondor, Assistance Publique – Hôpitaux de Paris Paris France

24. Médecine Intensive Réanimation, CHU de Nantes Université de Nantes Nantes France

25. Critical Care Unit Queen Elizabeth University Hospital Glasgow UK

26. Service de réanimation médico‐chirurgicale Hôpital Avicenne, Assistance Publique – Hôpitaux de Paris Paris France

27. Médecine Intensive Réanimation Hôpital Louis Mourier, Assistance Publique – Hôpitaux de Paris, DMU ESPRIT Paris France

28. Université Paris Cité, INSERM UMR‐S1151, CNRS UMR‐S8253 Institut Necker‐Enfants Malades Paris France

29. Service de Médecine Intensive‐Réanimation, Hôpital Saint‐Antoine, Assistance Publique – Hôpitaux de Paris Sorbonne Université Paris France

30. Department of Intensive Care Holbaek Hospital Holbaek Denmark

31. Department of Intensive Care Hospital General Granollers Barcelona Spain

32. Intensive Care Department Vall d'Hebron Hospital Universitari Barcelona Spain

33. SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR) Vall d'Hebron Barcelona Hospital Campus Barcelona Spain

34. Service de Médecine Intensive‐Réanimation, Hôpital Pitié‐Salpêtrière, Assistance Publique – Hôpitaux de Paris Sorbonne Université Paris France

35. Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Sorbonne Université Centre de Recherche Saint‐Antoine UMRS_938 INSERM Paris France

36. Department of Anaesthesia and Intensive Care Copenhagen University Hospital – Bispebjerg and Frederiksberg Copenhagen Denmark

37. Department of Intensive Care Copenhagen University Hospital – Herlev and Gentofte Herlev Denmark

38. Department of Anaesthesia and Intensive Care Haukeland University Hospital Bergen Norway

39. Faculty of Medicine University of Bergen Bergen Norway

40. Department of Anaesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Rikshospitalet Oslo University Hospital Oslo Norway

41. Department of Intensive Care Zealand University Hospital – Roskilde Roskilde Denmark

42. Department of Acute Medicine Oslo University Hospital Oslo Norway

43. Institute of Clinical Medicine University of Oslo Oslo Norway

44. Department of Intensive Care Stavanger University Hospital Stavanger Norway

45. Department of Anaesthesiology and Intensive Care Copenhagen University Hospital – North Zealand Hilleroed Denmark

46. Department of Intensive Care Medicine St. Olav's University Hospital Trondheim Norway

47. Department of Circulation and Medical Imaging Norwegian University of Technology and Science Trondheim Norway

48. Médecine Intensive & Réanimation, Hôpital Necker, Assistance Publique – Hôpitaux de Paris Université Paris Cité Paris France

49. Department of Intensive Care Hospital da Luz Lisboa Lisbon Portugal

50. Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation Hannover Medical School Hannover Germany

51. Department of Anaesthesiology Copenhagen University Hospital – Amager and Hvidovre Hvidovre Denmark

52. Intensive Care Unit Hospital Professor Doutor Fernando Fonseca, EPE Amadora Portugal

53. Department of Intensive Care B203 Akershus University Hospital Lorenskog Norway

54. Department of Intensive Care Medicine – Unit 2 Hospital Egas Moniz – CHLO, EPE Lisbon Portugal

Abstract

AbstractBackgroundPlatelet 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 methodsSub‐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.ResultsAmongst 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.ConclusionsAmong 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.

Funder

Dagmar Marshalls Fond

Publisher

Wiley

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/aas.14467

Reference48 articles.

1. Thrombocytopenia in medical-surgical critically ill patients: prevalence, incidence, and risk factors

2. Thrombocytopenia in intensive care unit patients: A scoping review