Effect of platelet storage duration on platelet increment and clinical outcomes in critically ill patients – A randomised controlled trial

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique Pub Date : 2025-02-01 DOI:10.1016/j.tracli.2024.11.001

Vivek Muraleedharan , Paramjit Kaur , Kshitija Mittal , Sanjeev Palta , Ravneet Kaur , Gagandeep Kaur

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引用次数: 0

Abstract

Background and objectives

Platelet storage duration may influence transfusion effectiveness and patient outcomes.The present study aimed to evaluate the effect of platelet storage duration on platelet increment and clinical outcomes in patients admitted to the intensive care unit (ICU).

Material and methods

This prospective, open-label, randomized controlled trial, conducted at a single centre, enrolled ICU patients requiring platelet transfusion. Patients were randomly assigned to receive platelet concentrates aged ≤ 3 days (Group 1) or 4–5 days (Group 2). Platelet increments were assessed by Absolute Platelet Count Increment (ACI), Corrected Count Increment (CCI), and Percentage Platelet Recovery (PPR). Clinical outcomes including bleeding, infection rates, ICU stay, red cell transfusion requirements, and mortality were also monitored.

Results

Patients transfused fresher platelets (Group 1) had higher median ACI, CCI and PPR at 1 h compared to those transfused older platelets (Group 2) though the difference was not statistically significant. At 24 h, Group 1 patients had a median ACI of 28,000/µl compared to 14,000/µl in Group 2(p = 0.001). The median CCI was 16,800 in Group 1 versus 8,200 in Group 2(p = 0.001). Group 1 also had a higher median PPR of 45.7% compared to 23.6% in Group 2(p = 0.011).There was no significant difference in clinical outcomes such as bleeding, infection rates, ICU stay, or mortality between the groups. Multivariate analysis indicated that co-morbidities and higher APACHE-III score were associated with increased mortality.

Conclusion

Transfusion of fresher platelets resulted in higher increments and transfusion effectiveness but did not affect clinical outcomes or mortality.

Trial registration details

Clinical Trials Registry of India (CTRI/2023/03/050676).

查看原文本刊更多论文

血小板储存时间对重症患者血小板增量和临床疗效的影响--随机对照试验。

背景和目的：本研究旨在评估血小板储存时间对重症监护病房（ICU）患者血小板增量和临床疗效的影响：这项前瞻性、开放标签、随机对照试验在一个中心进行，招募了需要输注血小板的重症监护病房患者。患者被随机分配接受≤3 天（第 1 组）或 4-5 天（第 2 组）的血小板浓缩液。血小板增量通过血小板绝对计数增量（ACI）、校正计数增量（CCI）和血小板恢复百分比（PPR）进行评估。此外，还对出血、感染率、重症监护室住院时间、红细胞输注需求和死亡率等临床结果进行了监测：结果：输注较新鲜血小板的患者（第 1 组）与输注较陈旧血小板的患者（第 2 组）相比，1 小时后的 ACI、CCI 和 PPR 中位数更高，但差异无统计学意义。第 1 组患者的 CCI 中位数为 16 800，而第 2 组为 8 200（P = 0.001）。第 1 组的中位 PPR 也更高，为 45.7%，而第 2 组为 23.6%（P = 0.011）。两组之间在出血、感染率、重症监护室住院时间或死亡率等临床结果方面没有显著差异。多变量分析表明，合并疾病和 APACHE-III 评分越高，死亡率越高：结论：输注更新鲜的血小板可获得更高的增量和输注效果，但不会影响临床结果或死亡率。试验登记详情：印度临床试验注册中心（CTRI/2023/03/050676）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion Clinique et Biologique 医学-免疫学

CiteScore

2.50

自引率

11.80%

发文量

234

审稿时长

36 days

期刊介绍： Transfusion Clinique et Biologique, the official journal of the French Society of Blood Transfusion (SFTS): - an aid to training, at a European level - the only French journal indexed in the hematology and immunology sections of Current Contents Transfusion Clinique et Biologique spans fundamental research and everyday practice, with articles coming from both sides. Articles, reviews, case reports, letters to the editor and editorials are published in 4 editions a year, in French or in English, covering all scientific and medical aspects of transfusion: immunology, hematology, infectious diseases, genetics, molecular biology, etc. And finally, a convivial cross-disciplinary section on training and information offers practical updates. Readership: "Transfusers" are many and various: anesthetists, biologists, hematologists, and blood-bank, ICU and mobile emergency specialists...