Use of Low-Dose Platelets in Actively Bleeding Patients: A Retrospective Analysis of a Cardiac Surgery Cohort.

Caitlin Raymond, Ashlie Atchison, Sri Bharathi Kavuri, Colby Elder, Scott Lick, David Guerra, Justin B L Halls, Stephen Cheney, Christoper J Zahner, Robert L Kruse
{"title":"Use of Low-Dose Platelets in Actively Bleeding Patients: A Retrospective Analysis of a Cardiac Surgery Cohort.","authors":"Caitlin Raymond, Ashlie Atchison, Sri Bharathi Kavuri, Colby Elder, Scott Lick, David Guerra, Justin B L Halls, Stephen Cheney, Christoper J Zahner, Robert L Kruse","doi":"10.5858/arpa.2024-0102-OA","DOIUrl":null,"url":null,"abstract":"<p><strong>Context.—: </strong>During platelet shortages, many hospitals produce low-dose platelets by splitting a standard platelet unit (>3 × 1011 platelets in the United States) in 2, then providing these low-dose units to patients. While low-dose units were previously found to be effective for prophylactic purposes in patients undergoing chemotherapy in the Prophylactic Platelet Dose (PLADO) trial, their use in actively bleeding patients has not yet been assessed.</p><p><strong>Objective.—: </strong>To assess the use and safety of low-dose platelets in actively bleeding patients.</p><p><strong>Design.—: </strong>We performed a retrospective review of cardiac surgery cases receiving platelet units for 18 months at 1 hospital. Two cohorts, those receiving only whole-dose platelets (37 cases) and those receiving only low-dose platelets (38 cases), were compared during the intraoperative and the 24-hour perioperative period. Mean number of platelet transfusions, dose of other blood products, estimated blood loss, bleeding complications in index cases, and all-cause mortality within 30 days of discharge were compared.</p><p><strong>Results.—: </strong>There was no significant difference in mean number of intraoperative platelet transfusions between the cohorts (1.61 versus 1.53, P = .57). There was no significant increase in the transfusion of other blood products, estimated blood loss, bleeding complications in index cases, or all-cause mortality within 30 days of discharge in the low-dose platelet cohort, apart from a small increase in requirement for fresh frozen plasma in the perioperative period.</p><p><strong>Conclusions.—: </strong>These results suggest that low-dose platelets are tentatively equivalent to whole-dose platelets in cardiac surgery during shortages, with similar transfusion requirements and clinical outcomes between groups. Future multicenter studies are needed to confirm these findings.</p>","PeriodicalId":93883,"journal":{"name":"Archives of pathology & laboratory medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of pathology & laboratory medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5858/arpa.2024-0102-OA","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Context.—: During platelet shortages, many hospitals produce low-dose platelets by splitting a standard platelet unit (>3 × 1011 platelets in the United States) in 2, then providing these low-dose units to patients. While low-dose units were previously found to be effective for prophylactic purposes in patients undergoing chemotherapy in the Prophylactic Platelet Dose (PLADO) trial, their use in actively bleeding patients has not yet been assessed.

Objective.—: To assess the use and safety of low-dose platelets in actively bleeding patients.

Design.—: We performed a retrospective review of cardiac surgery cases receiving platelet units for 18 months at 1 hospital. Two cohorts, those receiving only whole-dose platelets (37 cases) and those receiving only low-dose platelets (38 cases), were compared during the intraoperative and the 24-hour perioperative period. Mean number of platelet transfusions, dose of other blood products, estimated blood loss, bleeding complications in index cases, and all-cause mortality within 30 days of discharge were compared.

Results.—: There was no significant difference in mean number of intraoperative platelet transfusions between the cohorts (1.61 versus 1.53, P = .57). There was no significant increase in the transfusion of other blood products, estimated blood loss, bleeding complications in index cases, or all-cause mortality within 30 days of discharge in the low-dose platelet cohort, apart from a small increase in requirement for fresh frozen plasma in the perioperative period.

Conclusions.—: These results suggest that low-dose platelets are tentatively equivalent to whole-dose platelets in cardiac surgery during shortages, with similar transfusion requirements and clinical outcomes between groups. Future multicenter studies are needed to confirm these findings.

在主动出血患者中使用低剂量血小板:对心脏手术队列的回顾性分析
背景:在血小板短缺期间,许多医院通过将一个标准血小板单位(在美国大于 3 × 1011 个血小板)一分为二来生产低剂量血小板,然后将这些低剂量单位提供给患者。虽然此前在预防性血小板剂量(PLADO)试验中发现低剂量单位对化疗患者的预防性治疗有效,但尚未对其在活动性出血患者中的应用进行评估:评估低剂量血小板在活动性出血患者中的使用情况和安全性:我们对一家医院接受血小板治疗 18 个月的心脏手术病例进行了回顾性分析。在术中和围术期 24 小时内,我们对两组患者进行了比较,即仅接受全剂量血小板的患者(37 例)和仅接受低剂量血小板的患者(38 例)。比较了输注血小板的平均次数、其他血液制品的剂量、估计失血量、指标病例的出血并发症以及出院后 30 天内的全因死亡率:两组患者术中血小板输注的平均次数无明显差异(1.61 对 1.53,P = .57)。除了围手术期对新鲜冰冻血浆的需求略有增加外,低剂量血小板组的其他血液制品输注、估计失血量、指标病例出血并发症或出院后 30 天内的全因死亡率均无明显增加:这些结果表明,在血小板短缺的情况下,低剂量血小板在心脏手术中的作用暂时等同于全剂量血小板,各组间的输血需求和临床结果相似。未来需要进行多中心研究来证实这些结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信