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Platelet transfusions in pediatric intensive care units (PICUs) were linked to increased risks of multiple organ dysfunction syndrome and mortality. Key determinants for transfusion included low platelet counts and active bleeding, with 7.1% of children receiving transfusions.

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Area of Science:

  • Pediatric critical care medicine
  • Hematology
  • Transfusion medicine

Background:

  • Platelet transfusions are critical for managing bleeding in critically ill children.
  • Understanding the factors influencing transfusion decisions and their outcomes is essential for optimizing patient care.

Purpose of the Study:

  • To identify the determinants of platelet transfusion in a pediatric intensive care unit (PICU).
  • To investigate the association between platelet transfusion and adverse outcomes in this population.

Main Methods:

  • Prospective observational study conducted at a single university-affiliated tertiary care institution.
  • Data collected from 842 consecutive PICU admissions over one year.
  • Analysis included univariate and multivariate assessments of transfusion determinants and outcomes.

Main Results:

  • 7.1% of patients received platelet transfusions.
  • Significant determinants for transfusion included thrombocytopenia (platelet count < 50 × 10/L), age < 12 months, malignancy, shock, and multiple organ dysfunction syndrome.
  • Platelet transfusions were associated with increased risk of multiple organ dysfunction syndrome (OR, 2.53) and mortality (OR, 10.1).

Conclusions:

  • Thrombocytopenia and active bleeding are primary indications for platelet transfusion in the PICU.
  • Platelet transfusions in critically ill children are associated with adverse outcomes, including increased mortality and development of multiple organ dysfunction syndrome.