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Published on: January 31, 2018
Pre-procedural platelet transfusion thresholds in hospitalised children - Protocol for a scoping review
Lars Broksø Holst1, Arash Afshari1, Morten Hylander Møller2,3
1Department of Paediatric and Obstetric Anaesthesia, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Insights
This review examines the benefits and harms of prophylactic platelet transfusions for hospitalized children with low platelet counts undergoing invasive procedures. It aims to guide future research on this common critical care practice.
Area of Science:
- Pediatric Critical Care Medicine
- Hematology
- Evidence Synthesis
Background:
- Thrombocytopenia is frequent in critically ill hospitalized children.
- Platelet transfusions are often given prophylactically before invasive procedures in non-bleeding children.
- Clinical practice varies, and potential adverse effects exist.
Purpose of the Study:
- To assess current evidence on prophylactic platelet transfusions in hospitalized thrombocytopenic children undergoing invasive procedures.
- To identify benefits and harms associated with this practice.
- To inform future research directions.
Main Methods:
- A scoping review following PRISMA guidelines will be conducted.
- Studies involving hospitalized children, invasive procedures, thrombocytopenia, and relevant outcomes (bleeding, adverse events, blood product use, life support) will be included.
- Descriptive analyses and GRADE assessment of evidence quality will be performed.
Main Results:
- This section will present a descriptive analysis of included studies.
- The quality of evidence regarding prophylactic platelet transfusions will be assessed.
- An overview of benefits and harms will be synthesized.
Conclusions:
- The scoping review will summarize the current evidence on prophylactic platelet transfusions in this pediatric population.
- It will provide a foundation for understanding the risks and benefits.
- The findings will help direct future research efforts in pediatric critical care and hematology.
Background:
Thrombocytopenia is a common condition in hospitalised critically ill children and most platelet transfusions are given as prophylaxis to non-bleeding children prior to invasive procedures such as central venous catheterisation and lumbar puncture. Platelet transfusion may reduce bleeding complications but have also been associated with potential adverse effects and variation in clinical practice exist. To direct future research, we aim to assess the current evidence regarding prophylactic platelet transfusion prior to procedures in hospitalised thrombocytopenic children.
Methods:
We will conduct a scoping review of all study designs in accordance with the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) statement. We will include studies on hospitalised children undergoing invasive procedures where the prevalence of thrombocytopenia and the predefined outcome measures, including bleeding, transfusion-related adverse events and use of blood products and life support are reported. We will provide descriptive analyses of the included studies/trials and the quality of evidence will be assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
Conclusion:
The outlined scoping review will provide an overview on the benefits and harms of prophylactic platelet transfusion prior to invasive procedures in thrombocytopenic hospitalised children.
