Prophylactic platelet transfusion response in critically ill patients: a prospective multicentre observational study

Area of Science:

• Critical Care Medicine
• Hematology
• Transfusion Medicine

Background:

• Prophylactic platelet transfusions are common in critically ill patients but response can be inconsistent.
• Optimizing transfusion practices is crucial for improving patient outcomes.

Purpose of the Study:

• To describe prophylactic platelet transfusion response in critically ill patients.
• To identify factors associated with suboptimal response.
• To determine the impact of poor response on clinical outcomes.

Main Methods:

• Prospective multicentre observational study of 472 prophylactic platelet transfusions in intensive care units.
• Poor response defined as corrected count increment (CCI) < 7 at 18-24 hours post-transfusion.
• Mixed-effect model used to assess factors associated with poor response.

Main Results:

• 73.9% of transfusions and 77.9% of patients showed a poor platelet transfusion response.
• Factors associated with poor response included hematological malignancy, sepsis, higher SOFA score, and longer platelet storage duration.
• Hemoglobin and BMI were associated with better response.

Conclusions:

• Suboptimal platelet increment is frequent following prophylactic transfusions in critically ill patients.
• Platelet storage duration is an intervention-accessible factor linked to poor response.
• Clinical outcomes did not significantly differ based on transfusion response.