(2006) Utilization of platelet transfusions in the intensive care unit: indications, transfusion triggers, and platelet count responses. Reference 1: Arnold DM, Crowther MA, Cook RJ, et al. Further research is warranted to investigate whether changes in the identified independent risk factors for PT inefficacy improve patients’ outcomes. The mixed effect model identified haemoglobin (Estimate (E): 1.83 p = 0.0051), heart pulse before transfusion (Estimate: − 0.17 p = 0.016), curative anticoagulation (E: 14.1 p = 0.008), chronic kidney injury (E: 20.12 p = 0.008) and mean age of platelet transfused (E: − 3.21 p = 0.009) being independently associated with the CCI.Ĭonclusion: Almost half of preventive PT in ICU do not meet efficacy criteria based on the CCI. Interestingly, ABO compatibility did not affect PT efficacy. Among clinical features, PT inefficacy was associated with higher heart pulse (106 versus 99 p < 0.0001) and higher temperature prior to PT (37.2 versus 37 p = 0.016), both possible surrogate of sepsis. Demographic and baseline characteristics associated with preventive PT inefficacy in the univariate analysis were younger age (57.7 years versus 62.5 p = 0.01) immunosuppression (69.9% versus 51.8% p = 0.025) and lower haemoglobin (8.5 g/dL versus 9.7 g/dL p = 0.0028). Inefficacy criteria were met in 297 episodes (43.7%). PT efficacy according to the CCI was assessed in 679 preventive transfusion. Of the 975 transfusion episodes, 765 were given in prevention of bleeding because of low platelet count and 210 in treatment of active bleeding. Results: Of the 310 included patients, 119 patients (38.4%) received curative PT while 191 patients (61.6%) were treated preventively. Factors associated with transfusion inefficacy were assessed by performing an univariate analysis and in a mixed effect model.
Inefficacy of preventive PT was defined as a Corrected Count Increment (CCI, that adjusts for the transfused platelet dose and the body weight) < 7 at 18 to 24 h after PT. Patients and methods/Materials and methods: From June 2018 to November 2019, we conducted a prospective multicenter observational study recruiting patients that received at least one PT in one of the 9 participating ICUs.
This study aims to describe the efficacy of PT in ICU, and its impact on patients’ outcomes. Both preventive and therapeutic platelet transfusions (PT) are not fully supported by high levels of evidence and the benefits of platelet transfusion remain subject to debates in some settings. Rationale: Up to 15% of critically ill patients receive platelets in intensive care units (ICU) (1). CO-01 Platelet transfusion efficacy in intensive care unit: a prospective multicenter observational REIZINE Florian 1, LE MAREC Sarah 2, LE MEUR Anthony 3, CONSIGNY Maëlys 2, BERTEAU Florian 1, GESLAIN Marie 2, LE NIGER Catherine 2, HUNTZINGER Julien 5, SEGUIN Philippe 1, THIBERT Jean-Baptiste 6, REIGNIER Jean 3, EGRETEAU Pierre-Yves 4, TADIÉ Jean-Marc 1, HUET Olivier 1, ASFAR Pierre 7, EHRMANN Stephan 8, AUBRON Cécile 2 1CHU de Rennes, Rennes, France 2CHU de Brest, Brest, France 3CHU de Nantes, Nantes, France 4CH de Morlaix, Morlaix, France 5CH de Vannes, Vannes, France 6Etablissement français du sang Bretagne, Rennes, France 7CHU d’Angers, Angers, France 8CHU de Tours, Tours, France Correspondence: Florian REIZINE of Intensive Care 2022, 12(1):CO-01
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