Stefan F van Wonderen, Senta Jorinde Raasveld, Andrew W J Flint, Jimmy Schenk, Claudia van den Oord, Merijn C Reuland, Sanne de Bruin, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Jens Meier, Marcella C A Müller, Thomas W L Scheeren, Tarikul Hamid, Michaël Piagnerelli, Tina Tomić Mahečić, Jan Benes, Lene Russell, Hernan Aguirre-Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V Llau, Manual Quintana-Diaz, Maria Cronhjort, Carmen A Pfortmueller, Nihan Yapici, Nathan D Nielsen, Akshay Shah, Harm-Jan de Grooth, Zoe McQuilten, Alexander P J Vlaar, Cécile Aubron
{"title":"ICU血小板输注实践：一项前瞻性多中心队列研究。","authors":"Stefan F van Wonderen, Senta Jorinde Raasveld, Andrew W J Flint, Jimmy Schenk, Claudia van den Oord, Merijn C Reuland, Sanne de Bruin, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Jens Meier, Marcella C A Müller, Thomas W L Scheeren, Tarikul Hamid, Michaël Piagnerelli, Tina Tomić Mahečić, Jan Benes, Lene Russell, Hernan Aguirre-Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V Llau, Manual Quintana-Diaz, Maria Cronhjort, Carmen A Pfortmueller, Nihan Yapici, Nathan D Nielsen, Akshay Shah, Harm-Jan de Grooth, Zoe McQuilten, Alexander P J Vlaar, Cécile Aubron","doi":"10.1097/CCM.0000000000006880","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations.</p><p><strong>Design: </strong>International prospective cohort study.</p><p><strong>Setting: </strong>Two hundred thirty-three centers in 30 countries worldwide.</p><p><strong>Patients: </strong>All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to October 2022), were included.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Of the 3643 patients, 208 (6%) received a platelet transfusion during their ICU stay and main indications consisted of active bleeding (42%, n = 187/443), prophylaxis (33%, n = 144/443) or an upcoming procedure (12%, n = 51/443). The median platelet count before transfusion was 44 × 109/L (interquartile range [IQR], 20-78) with variation by indication, including a higher median of 60 × 109/L (IQR 31-93) during active bleeding. A threshold for transfusion was stated in 51% (n = 224/443) of the events, with a median threshold platelet count of 50 × 109/L (IQR, 40-100). The advised threshold was not adhered to in 16% (n = 36/224) of cases, with the majority having active bleeding as indication. Contrasts in transfusion practices were observed across different geo-economic regions. Platelet transfusions were administered to 6% (n = 156/2520) of patients in high-income countries, 5% (n = 52/1069) of patients in upper-middle-income countries and in none from lower-middle-income countries (n = 0/54). Non-adherence was higher in the high-income countries (23%, n = 34/149) than upper-middle-income countries (3%, n = 2/75).</p><p><strong>Conclusions: </strong>Platelet transfusions were administered to a small proportion of critically ill patients, and were given to treat active bleeding or as prophylaxis in the majority of cases. Occurence rate, indication and threshold adherence for platelet transfusion widely varied between geo-economic regions.</p>","PeriodicalId":10765,"journal":{"name":"Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":6.0000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Platelet Transfusion Practices in the ICU: A Prospective Multicenter Cohort Study.\",\"authors\":\"Stefan F van Wonderen, Senta Jorinde Raasveld, Andrew W J Flint, Jimmy Schenk, Claudia van den Oord, Merijn C Reuland, Sanne de Bruin, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Jens Meier, Marcella C A Müller, Thomas W L Scheeren, Tarikul Hamid, Michaël Piagnerelli, Tina Tomić Mahečić, Jan Benes, Lene Russell, Hernan Aguirre-Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V Llau, Manual Quintana-Diaz, Maria Cronhjort, Carmen A Pfortmueller, Nihan Yapici, Nathan D Nielsen, Akshay Shah, Harm-Jan de Grooth, Zoe McQuilten, Alexander P J Vlaar, Cécile Aubron\",\"doi\":\"10.1097/CCM.0000000000006880\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations.</p><p><strong>Design: </strong>International prospective cohort study.</p><p><strong>Setting: </strong>Two hundred thirty-three centers in 30 countries worldwide.</p><p><strong>Patients: </strong>All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to October 2022), were included.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Of the 3643 patients, 208 (6%) received a platelet transfusion during their ICU stay and main indications consisted of active bleeding (42%, n = 187/443), prophylaxis (33%, n = 144/443) or an upcoming procedure (12%, n = 51/443). The median platelet count before transfusion was 44 × 109/L (interquartile range [IQR], 20-78) with variation by indication, including a higher median of 60 × 109/L (IQR 31-93) during active bleeding. A threshold for transfusion was stated in 51% (n = 224/443) of the events, with a median threshold platelet count of 50 × 109/L (IQR, 40-100). The advised threshold was not adhered to in 16% (n = 36/224) of cases, with the majority having active bleeding as indication. Contrasts in transfusion practices were observed across different geo-economic regions. Platelet transfusions were administered to 6% (n = 156/2520) of patients in high-income countries, 5% (n = 52/1069) of patients in upper-middle-income countries and in none from lower-middle-income countries (n = 0/54). Non-adherence was higher in the high-income countries (23%, n = 34/149) than upper-middle-income countries (3%, n = 2/75).</p><p><strong>Conclusions: </strong>Platelet transfusions were administered to a small proportion of critically ill patients, and were given to treat active bleeding or as prophylaxis in the majority of cases. Occurence rate, indication and threshold adherence for platelet transfusion widely varied between geo-economic regions.</p>\",\"PeriodicalId\":10765,\"journal\":{\"name\":\"Critical Care Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":6.0000,\"publicationDate\":\"2025-09-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Critical Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/CCM.0000000000006880\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Critical Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/CCM.0000000000006880","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Platelet Transfusion Practices in the ICU: A Prospective Multicenter Cohort Study.
Objective: There is a lack of comprehensive international data regarding platelet transfusion practices in the ICU. This study aimed to evaluate the current occurrence rate of platelet transfusion in the ICU and provide an overview of platelet transfusion practices including indications for a platelet transfusion, thresholds, (non-)adherence and geo-economic region variations.
Design: International prospective cohort study.
Setting: Two hundred thirty-three centers in 30 countries worldwide.
Patients: All patients 18 years old and older, admitted to the ICU during a single study week, selected by each site from one of the 16 predefined weeks (March 2019 to October 2022), were included.
Interventions: None.
Measurements and main results: Of the 3643 patients, 208 (6%) received a platelet transfusion during their ICU stay and main indications consisted of active bleeding (42%, n = 187/443), prophylaxis (33%, n = 144/443) or an upcoming procedure (12%, n = 51/443). The median platelet count before transfusion was 44 × 109/L (interquartile range [IQR], 20-78) with variation by indication, including a higher median of 60 × 109/L (IQR 31-93) during active bleeding. A threshold for transfusion was stated in 51% (n = 224/443) of the events, with a median threshold platelet count of 50 × 109/L (IQR, 40-100). The advised threshold was not adhered to in 16% (n = 36/224) of cases, with the majority having active bleeding as indication. Contrasts in transfusion practices were observed across different geo-economic regions. Platelet transfusions were administered to 6% (n = 156/2520) of patients in high-income countries, 5% (n = 52/1069) of patients in upper-middle-income countries and in none from lower-middle-income countries (n = 0/54). Non-adherence was higher in the high-income countries (23%, n = 34/149) than upper-middle-income countries (3%, n = 2/75).
Conclusions: Platelet transfusions were administered to a small proportion of critically ill patients, and were given to treat active bleeding or as prophylaxis in the majority of cases. Occurence rate, indication and threshold adherence for platelet transfusion widely varied between geo-economic regions.
期刊介绍：
Critical Care Medicine is the premier peer-reviewed, scientific publication in critical care medicine. Directed to those specialists who treat patients in the ICU and CCU, including chest physicians, surgeons, pediatricians, pharmacists/pharmacologists, anesthesiologists, critical care nurses, and other healthcare professionals, Critical Care Medicine covers all aspects of acute and emergency care for the critically ill or injured patient.
Each issue presents critical care practitioners with clinical breakthroughs that lead to better patient care, the latest news on promising research, and advances in equipment and techniques.
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