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Updated: Sep 21, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Pediatric platelet transfusions in critical illness: a narrative review of recent studies
Christie Atchison1, Hera Mahmood2, Marianne E Nellis2
1Division of Critical Care Medicine, Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington.
Insights
Platelet transfusions carry risks, and new processing methods aim to improve safety. For critically ill children, restrictive transfusion thresholds are recommended due to limited evidence and significant risks.
Area of Science:
- Pediatric critical care medicine
- Transfusion medicine
- Hematology
Background:
- Platelet transfusions are vital but linked to morbidity and mortality.
- Infectious risks are a concern, prompting development of new processing techniques like pathogen reduction.
- Recent trials highlight potential harms of liberal transfusion strategies.
Purpose of the Study:
- To review current platelet transfusion practices in critically ill children.
- To examine harms associated with platelet transfusions.
- To discuss novel platelet processing methods and recent transfusion guidelines.
Main Methods:
- Literature review of current platelet transfusion use.
- Analysis of harms and adverse events associated with platelet transfusions.
- Evaluation of new platelet processing technologies and recent guidelines.
Main Results:
- Platelet transfusions are associated with significant morbidity and mortality.
- Pathogen reduction aims to mitigate infectious risks.
- A recent neonatal trial indicated increased bleeding and mortality with liberal platelet transfusion thresholds.
Conclusions:
- Evidence for platelet transfusion guidelines in critically ill children is limited.
- Restrictive transfusion thresholds should be considered due to the significant risks.
- Further research is needed to establish optimal transfusion strategies for pediatric patients.
Purpose Of Review:
We sought to describe the current use of platelet transfusions, harms associated with platelet transfusion, new methods of platelet processing that attempt to address these harms, and recent platelet transfusion guidance specific to critically ill children.
Recent Findings:
Platelet transfusions have been associated with significant morbidity and mortality. New processing techniques, such as pathogen reduction, have been developed to combat infectious risks but in a recent trial of platelet transfusion thresholds in neonates, transfusing platelets more liberally was associated with increased bleeding and mortality.
Summary:
Recent efforts to develop evidence-based guidelines for platelet transfusion in critically ill children were limited by the lack of evidence. However, given the significant risks, restrictive transfusion thresholds should be considered.
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