TY - JOUR
T1 - Platelet Transfusion Practices in the ICU
T2 - A Prospective Multicenter Cohort Study
AU - van Wonderen, Stefan F
AU - Raasveld, Senta Jorinde
AU - Flint, Andrew W J
AU - Schenk, Jimmy
AU - van den Oord, Claudia
AU - Reuland, Merijn C
AU - de Bruin, Sanne
AU - Bakker, Jan
AU - Cecconi, Maurizio
AU - Feldheiser, Aarne
AU - Meier, Jens
AU - Müller, Marcella C A
AU - Scheeren, Thomas W L
AU - Hamid, Tarikul
AU - Piagnerelli, Michaël
AU - Mahečić, Tina Tomić
AU - Benes, Jan
AU - Russell, Lene
AU - Aguirre-Bermeo, Hernan
AU - Triantafyllopoulou, Konstantina
AU - Chantziara, Vasiliki
AU - Gurjar, Mohan
AU - Myatra, Sheila Nainan
AU - Pota, Vincenzo
AU - Elhadi, Muhammed
AU - Gawda, Ryszard
AU - Mourisco, Mafalda
AU - Lance, Marcus
AU - Neskovic, Vojislava
AU - Podbregar, Matej
AU - Llau, Juan V
AU - Quintana-Diaz, Manual
AU - Cronhjort, Maria
AU - Pfortmueller, Carmen A
AU - Yapici, Nihan
AU - Nielsen, Nathan D
AU - Shah, Akshay
AU - de Grooth, Harm-Jan
AU - McQuilten, Zoe
AU - Vlaar, Alexander P J
AU - Aubron, Cécile
N1 - Publisher Copyright:
Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.
PY - 2025/12/1
Y1 - 2025/12/1
N2 - OBJECTIVE: There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations. DESIGN: International prospective cohort study. SETTING: Two hundred thirty-three centers in 30 countries worldwide. PATIENTS: All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to October 2022), were included.None. MEASUREMENTS AND MAIN RESULTS: Of the 3643 patients, 208 (6%) received a platelet transfusion during their ICU stay and main indications consisted of active bleeding (42%, n = 187/443), prophylaxis (33%, n = 144/443) or an upcoming procedure (12%, n = 51/443). The median platelet count before transfusion was 44 × 10 9 /L (interquartile range [IQR], 20-78) with variation by indication, including a higher median of 60 × 10 9 /L (IQR 31-93) during active bleeding. A threshold for transfusion was stated in 51% ( n = 224/443) of the events, with a median threshold platelet count of 50 × 10 9 /L (IQR, 40-100). The advised threshold was not adhered to in 16% ( n = 36/224) of cases, with the majority having active bleeding as indication. Contrasts in transfusion practices were observed across different geo-economic regions. Platelet transfusions were administered to 6% ( n = 156/2520) of patients in high-income countries, 5% ( n = 52/1069) of patients in upper-middle-income countries and in none from lower-middle-income countries ( n = 0/54). Non-adherence was higher in the high-income countries (23%, n = 34/149) than upper-middle-income countries (3%, n = 2/75). CONCLUSIONS: Platelet transfusions were administered to a small proportion of critically ill patients, and were given to treat active bleeding or as prophylaxis in the majority of cases. Occurence rate, indication and threshold adherence for platelet transfusion widely varied between geo-economic regions.
AB - OBJECTIVE: There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations. DESIGN: International prospective cohort study. SETTING: Two hundred thirty-three centers in 30 countries worldwide. PATIENTS: All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to October 2022), were included.None. MEASUREMENTS AND MAIN RESULTS: Of the 3643 patients, 208 (6%) received a platelet transfusion during their ICU stay and main indications consisted of active bleeding (42%, n = 187/443), prophylaxis (33%, n = 144/443) or an upcoming procedure (12%, n = 51/443). The median platelet count before transfusion was 44 × 10 9 /L (interquartile range [IQR], 20-78) with variation by indication, including a higher median of 60 × 10 9 /L (IQR 31-93) during active bleeding. A threshold for transfusion was stated in 51% ( n = 224/443) of the events, with a median threshold platelet count of 50 × 10 9 /L (IQR, 40-100). The advised threshold was not adhered to in 16% ( n = 36/224) of cases, with the majority having active bleeding as indication. Contrasts in transfusion practices were observed across different geo-economic regions. Platelet transfusions were administered to 6% ( n = 156/2520) of patients in high-income countries, 5% ( n = 52/1069) of patients in upper-middle-income countries and in none from lower-middle-income countries ( n = 0/54). Non-adherence was higher in the high-income countries (23%, n = 34/149) than upper-middle-income countries (3%, n = 2/75). CONCLUSIONS: Platelet transfusions were administered to a small proportion of critically ill patients, and were given to treat active bleeding or as prophylaxis in the majority of cases. Occurence rate, indication and threshold adherence for platelet transfusion widely varied between geo-economic regions.
U2 - 10.1097/CCM.0000000000006880
DO - 10.1097/CCM.0000000000006880
M3 - Article
C2 - 41002230
SN - 0090-3493
VL - 53
SP - e2526-e2539
JO - Critical care medicine
JF - Critical care medicine
IS - 12
ER -