title: The practice of platelet transfusion in the intensive care unit.
abstract: The practice of platelet transfusion in the intensive care unit varies, and liberal use may not be associated with improved outcome. This study reviewed the medical records of 117 patients with moderate-to-severe thrombocytopenia and without active bleeding who were admitted to intensive care unit beds during a 6-month period. The primary outcome measures were new bleeding episodes and platelet transfusion complications. Ninety (77%) received a platelet transfusion. Significant new bleeding developed in 1 patient who received a transfusion. Six patients (8%) developed transfusion complications: 2 transfusion-related acute lung injury, 2 allergic, and 2 febrile reactions. Patients who did not receive platelet transfusion had a higher severity of illness than transfused patients. Predictors of platelet transfusion were platelet count and postoperative status, but not invasive procedure. The practice of platelet transfusion in critically ill patients with thrombocytopenia varies. Prospective studies evaluating restrictive versus liberal platelet transfusion strategies are warranted.
authors.affiliation: Pulmonary and Critical Care Medicine, Graduate Hospital, Philadelphia, PA, USA.
authors.forename: Salam S
authors.initials: SS
authors.lastname: Salman
authors.forename: Evans R
authors.initials: ER
authors.lastname: Fernández Pérez
authors.forename: James R
authors.initials: JR
authors.lastname: Stubbs
authors.forename: Ognjen
authors.initials: O
authors.lastname: Gajic
mesh_terms: D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D010976:Platelet Count; D017713:Platelet Transfusion / Q000009:adverse effects*; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000145:classification / Q000628:therapy*; D016896:Treatment Outcome