The association between platelet transfusions and bleeding in critically ill patients with thrombocytopenia
Donald M. Arnold(Canadian Blood Services), François Lauzier(Hôpital de l'Enfant-Jésus), Martin Albert(Hôpital du Sacré-Cœur de Montréal), David Williamson(Université de Montréal), Na Li(McMaster University), Ryan Zarychanski(University of Manitoba), Chip Doig(University of Calgary), Lauralyn McIntyre(Ottawa Hospital), Andreas Freitag(McMaster University), Mark Crowther(McMaster University), Lois Saunders(McMaster University), France Clarke(McMaster University), Rinaldo Bellomo(Austin Hospital), Ismael Qushmaq(King Faisal Specialist Hospital & Research Centre), Renato D. Lópes(Duke Medical Center), Diane Heels‐Ansdell(McMaster University), Kathryn E. Webert(Canadian Blood Services), Deborah Cook(McMaster University), Rick Hall, Graeme Rocker, Lisa Julien, Debbie Wright, Caroline Le Roy, Judy Theriault, Susan Pleasance, Maureen O. Meade, Lori Hand, Lois Saunders(McMaster University), Christine Wynne, Mark Duffett(McMaster University), Michelle E. Kho, Nicole Zytaruk, John Granton, Andrea Matte(McMaster University), Paulina Farías, Leslie M. Chu, Nancy Brockest, Stephanie Go, Margaret McGrath‐Chong, Madison Dennis, Marc Lipkus, Emily Stern, Ryan Albert(Hôpital du Sacré-Cœur de Montréal), Stéphan Langevin, Alexis F. Turgeon, Marie‐Claude Tremblay, Martine Blais, Maxime Beauparlant, Julie Asselin, Chantal Gagne, Marie Pierre Thibodeau, Germain Poirier, Sandrine Spearson, Isabelle Neas, Joe Pagliarello, Lauralyn McIntyre(Ottawa Hospital), Paul C. Hébert, Irene Watpool, Tracy McArdle, Claude Gaudert, P Marchand, Carson Davidson, Mary‐Jo Lewis, Erin Murphy, Julia Foxall, Yoanna Skrobik, Johanne Harvey, Stefania Chitu, Virginie Williams(Université de Montréal), Carole Sirois, Carole Nadon, Stephanie Dolle, Audrey‐Anne Gosselin, P Deroy, Geeta Mehta, Sumesh Shah, Cheryl Ethier, Sam Tirgari, Lindsay Steinberg, Rod McDonald, Vidhya Sivanantham, Kristofer Bandayrel, Friederike Quittnat Pelletier, Marnie Kramer, Maedean Brown, Scott Kim, Rob Fowler, Nicole Marinoff, Karen I. Code, Boris Bojilov, Derek Parsotam, Marshall John, Orla Smith, Beth Fry, Kerri Porretta, Yoon Lee, Jeanna Morrissey, Victoria W. Wen, John Muscedere, Miranda Hunt, Susan Fleury, Nicole Godfrey, Sharlene Hammond, Elizabeth K. Mann, M Myers, Amber Robinson, Donald Griesdale(Canadian Blood Services), Dean R. Chittock, Vinay Dhingra, Denise Foster, Maureen Gardner, Susan Logie, Roger Autio, D. Wyn Davies, Pia Ganz, Laurie D. Smith, Peter Dodek, Victoria Alcuaz, Betty Jean Ashley, Sheilagh Mans, John Granton, Niall D. Ferguson, Andrea Matte(McMaster University), James Stevenson, Joel Elman, Madison Dennis, Timothy Karachi, Tina Millen(Hôpital du Sacré-Cœur de Montréal), Andrea Tkaczyk(McMaster University), Mike Jacka, Marleen Irwin, Carmen Chan(University of Manitoba), Leeca Sonnema, Kelly Marsh, J.R. Maurer, T. J. Kreidl, Candice Varden, Carey Kinjerski, Christopher Doig(University of Calgary), Stacy Ruddell, Linda Knox, Crystal Wilson, Kevin Champagne, Gordon Wood, F. C. Auld, Leslie Atkins, Bojan Paunovic, Nicole Marten, K Wiebe, Nicole Zytaruk, Ellen McDonald, Andrea Tkaczyk(McMaster University), Sean Keenan, Steven Reynolds, Miroslav Svetik, Mary Van Osch, Linda Knox, Crystal Wilson, Kevin Champagne, Jim Kutsogiannis, Patrica Thompson, Norine Whalen, François Lellouche(Hôpital de l'Enfant-Jésus), M Ferland, Patrick H. Dussault, Caroline Jacob, Marie‐Eve Morneau, Nancy Laberge, Kosar Khwaja, Laura Banici(Ottawa Hospital), Carole Sirois, Lena Havell, Olivier Lesur, François Lamontagne(Hôpital de l'Enfant-Jésus), Sandra Proulx, Kosar Khwaja, Laura Banici(Ottawa Hospital), Carole Sirois, Lena Havell, Gerald Hollinger, Vasanti Shende, Vanessa Belcastro, Bill Plaxton, Anders Foss, Jonathan Eisenstat, Tammy Doerle, Steven Reynolds, Sean Keenan, Sheilagh Mans, Michael Sharpe, Mona Madady, Jamie Cooper, Andrew Davies, Shirley Vallance, Cindy Weatherburn, Jasmin Board, Victoria Bennett, Simon Finfer, Naresh Ramakrishnan, Simon Bird, Julie Potter, Anne O’Connor, Susan Ankers, J. F. J. Cade, Deborah Barge(McMaster University), Tania Caf, Belinda Howe, Rinaldo Bellomo(Austin Hospital), Glenn M. Eastwood, Leah Peck, Donna Goldsmith, Kim O’Sullivan, David Ernest(Université de Montréal), Sam Radford, Ann Whitfield, Anthony Cross, Suzanne Eliott, Jaspreet Kaur Sidhu, Belinda Howe, Inga Mercer, Angela Hamilton, John Botha, Jodi Vuat, Sharon Allsop, Nina Fowler, Tim Crozier, Jonathan Barrett, Chris Wright, Pauline Galt, Carly Culhane, Rebecca Ioannidis, Susan Burton, Marnie Reily, Cyveen Weeraratna, Ian Seppelt(McMaster University), Leonie Weisbrodt, Robyn Bond, Justine Rivett, Stephanie O’Connor, Alexis Poole, Clive Woolfe, Dorrilyn Rajbhandari, Caitlin Rees, John Edington, Jason Fletcher, Julie Smith, Catherine Boschert, Graham Reece, Treena Sara, Kiran Nand, Andrew D. Bersten, Alexander Gallus, Elisha Matheson, Margie O’Callaghan, Neil Orford, Tania Elderkin, Melissa A. Fraser, Allison Bone, Tania Salerno, Anne Kinmonth, Subhash Arora, Bridget O’Bree, Katherine Shepherd, Alan –Quinn, Martin Štěrba, Bronwyn Ruth Johnson(Hôpital du Sacré-Cœur de Montréal), Renee Xu, F. G. H. Hill, Rajaram Ramadoss, Josette Wood, Marcelo Rocha, Andréa Kramer, Martha Hädrich(McMaster University), Nilton Brandão, Cassiano Teixeira, Cíntia Roehrig, Juliana Zeni, Suzana Alves da Silva, Rubens Costa Filho, Renato Girade Corrêa, Alves Moreira(Duke Medical Center), Plínio N. Gomes, Rodrigo Biondi, Otávio Berwanger, Edson Romano, Anna Maria Buehler, Hélio Penna Guimarães, Adriano A. M. Truffa, Rosana Ely Nakamura, Lillian Mazza Barbosa, Jean Brennick, Sawsan Bassi, Mohammed Al‐Sultan, Yaseen M. Arabi, Riette Brits, Jamal A. Alhashemi, Sanaa A. Shalabi, Yasser Mandourah, Nadeem Shaikh, Manal Al‐Hazmi, M. Ali Al‐Azem, Trevor Wyngaard(Duke Medical Center), Barbara Smithson, Nicholas E. Vlahakis, Laurie Meade, Michael J. Cox, Jackie O’Brien, Catherine Krause, Joseph L. Nates, Sajid Haque, Deidre Mooring, Rose Erfe, Paula Nickerson, Tony Sherry, J. L. Smith, Barnaby Sanderson, Josephine Ng, John T. Brooks, Ling Lim, Katie Lei
Cited by 14Open Access
Abstract
BACKGROUND: Platelet transfusions are commonly used to treat critically ill patients with thrombocytopenia. Whether platelet transfusions are associated with a reduction in the risk of major bleeding is unknown. PATIENTS/METHODS: Observational cohort study nested in a previous multicenter, randomized thromboprophylaxis trial in the intensive care unit (ICU). The objective was to evaluate the association between platelet transfusions and adjudicated major bleeding events. Platelet transfusion episodes were reviewed for timing of administration, product type, and dose. Major bleeding with and without platelet transfusions was adjusted for severity of thrombocytopenia, use of anti-platelet agents, surgery and other covariates. Secondary outcomes were thrombosis, death in ICU and platelet count increment. RESULTS: /L at 3.5 hours post-transfusion. CONCLUSIONS: Rates of major bleeding were not different for patients who did and did not receive platelet transfusions. Inferences were limited by the small number of transfused patients. Clinical trials are needed to better investigate the potential hemostatic benefit and potential harms of platelet transfusions for this high-risk population.
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