Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Médecine Intensive & Réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, Paris, France.
Acta Anaesthesiol Scand. 2024 Sep;68(8):1018-1030. doi: 10.1111/aas.14467. Epub 2024 Jun 5.
Platelet transfusions are frequently used in the intensive care unit (ICU), but current practices including used product types, volumes, doses and effects are unknown.
Sub-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 × 10/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.
Amongst 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 × 10 platelets/transfusion) whilst some (mainly in France) used weight-based dosing (ranging from 0.5 to 0.7 × 10 platelets per 10 kg body weight). The median platelet count increment for a single prophylactic platelet transfusion was 2 (-1 to 8) × 10/L. Outcomes of patients with thrombocytopenia who did and did not receive platelet transfusions varied.
Among 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.
血小板输注在重症监护病房（ICU）中经常使用，但目前的实践包括使用的产品类型、体积、剂量和效果尚不清楚。
这项研究是“重症监护病房血小板减少症和血小板输注（PLOT-ICU）”起始队列研究的子研究，纳入了急性入住、伴有血小板减少症（血小板计数<150×10/L）的成年 ICU 患者。主要结局是按产品类型统计 ICU 中接受血小板输注的患者人数。次要结局包括血小板输注细节、血小板计数增加、出血、其他输血和死亡率。
在来自欧洲和美国 10 个国家的 43 家医院的 504 例血小板减少症患者中，有 20.8%接受了 565 次血小板输注；61.0%输注的是混合产品，21.9%输注的是单采产品，17.1%两者均输注，从入院到首次输注的中位数时间为 2（1 至 4 个四分位数间距）天。每次输注的中位数体积为 253（180-308）mL，混合产品占输注量的 59.1%，但各国之间存在差异。大多数中心（73.8%）使用固定剂量（中位数范围为 2.0 至 3.5×10 个血小板/次），而有些中心（主要在法国）使用基于体重的剂量（范围为 0.5 至 0.7×10 个血小板/10kg 体重）。单次预防性血小板输注的血小板计数中位数增加量为 2（-1 至 8）×10/L。有和没有接受血小板输注的血小板减少症患者的结局存在差异。
在急性入住的伴有血小板减少症的成年 ICU 患者中，有 20.8%接受了 ICU 中的血小板输注，其中大多数输注的是混合产品，但不同国家之间在产品类型、体积和剂量方面存在很大差异。预防性血小板输注可使血小板计数适度增加。
