Salman Salam S, Fernández Pérez Evans R, Stubbs James R, Gajic Ognjen
Pulmonary and Critical Care Medicine, Graduate Hospital, Philadelphia, PA, USA.
J Intensive Care Med. 2007 Mar-Apr;22(2):105-10. doi: 10.1177/0885066606297969.
The practice of platelet transfusion in the intensive care unit varies, and liberal use may not be associated with improved outcome. This study reviewed the medical records of 117 patients with moderate-to-severe thrombocytopenia and without active bleeding who were admitted to intensive care unit beds during a 6-month period. The primary outcome measures were new bleeding episodes and platelet transfusion complications. Ninety (77%) received a platelet transfusion. Significant new bleeding developed in 1 patient who received a transfusion. Six patients (8%) developed transfusion complications: 2 transfusion-related acute lung injury, 2 allergic, and 2 febrile reactions. Patients who did not receive platelet transfusion had a higher severity of illness than transfused patients. Predictors of platelet transfusion were platelet count and postoperative status, but not invasive procedure. The practice of platelet transfusion in critically ill patients with thrombocytopenia varies. Prospective studies evaluating restrictive versus liberal platelet transfusion strategies are warranted.
重症监护病房中血小板输注的做法各不相同，过度使用可能与改善预后无关。本研究回顾了117例中度至重度血小板减少且无活动性出血的患者的病历，这些患者在6个月期间入住了重症监护病房。主要结局指标为新的出血事件和血小板输注并发症。90例（77%）接受了血小板输注。1例接受输血的患者出现了严重的新出血。6例（8%）出现了输血并发症：2例输血相关急性肺损伤、2例过敏反应和2例发热反应。未接受血小板输注的患者病情比接受输注的患者更严重。血小板输注的预测因素是血小板计数和术后状态，而非侵入性操作。血小板减少的重症患者的血小板输注做法各不相同。有必要进行前瞻性研究，评估限制性与开放性血小板输注策略。
