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. 2022 Oct;66(9):1146-1155.
doi: 10.1111/aas.14124. Epub 2022 Aug 23.

Platelet transfusions and thrombocytopenia in intensive care units: Protocol for an international inception cohort study (PLOT-ICU)

Carl Thomas Anthon  1 , Frédéric Pène  2 , Anders Perner  1 , Elie Azoulay  3 , Kathryn Puxty  4 , Andry Van De Louw  5 , Andreas Barratt-Due  6 , Sanjay Chawla  7 , Pedro Castro  8 , Pedro Povoa  9   10 , Luis Coelho  9   10 , Victoria Metaxa  11 , Laveena Munshi  12 , Matthias Kochanek  13 , Tobias Liebregts  14 , Thomas Kander  15   16 , Johanna Hästbacka  17 , Morten Hylander Møller  1 , Lene Russell  1 ; PLOT-ICU Investigators and the Nine-I Study Group
Affiliations

Platelet transfusions and thrombocytopenia in intensive care units: Protocol for an international inception cohort study (PLOT-ICU)

Carl Thomas Anthon et al. Acta Anaesthesiol Scand. 2022 Oct.

Abstract

Introduction: Thrombocytopenia is frequent in intensive care unit (ICU) patients and has been associated with worse outcome. Platelet transfusions are often used in the management of ICU patients with severe thrombocytopenia. However, the reported frequencies of thrombocytopenia and platelet transfusion practices in the ICU vary considerably. Therefore, we aim to provide contemporary epidemiological data on thrombocytopenia and platelet transfusion practices in the ICU.

Methods: We will conduct an international inception cohort, including at least 1000 acutely admitted adult ICU patients. Routinely available data will be collected at baseline (ICU admission), and daily during ICU stay up to a maximum of 90 days. The primary outcome will be the number of patients with thrombocytopenia (a recorded platelet count < 150 × 109 /L) at baseline and/or during ICU stay. Secondary outcomes include mortality, days alive and out of hospital, days alive without life-support, the number of patients with at least one bleeding episode, at least one thromboembolic event and at least one platelet transfusion in the ICU, the number of platelet transfusions and the indications for transfusion. The primary and secondary outcomes will be presented descriptively. In addition, we will assess risk factors for developing thrombocytopenia during ICU stay and the association between thrombocytopenia at baseline and 90-day mortality using logistic regression analyses.

Conclusion: The outlined international PLOT-ICU cohort study will provide contemporary epidemiological data on the burden and clinical significance of thrombocytopenia in adult ICU patients and describe the current platelet transfusion practice.

Keywords: intensive care unit; platelet transfusion; thrombocytopenia.

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Conflict of interest statement

The Department of Intensive Care 4131 at Rigshospitalet (CTA, MHM, AP, LR) has received funding for other projects from the Novo Nordisk Foundation, Pfizer, Ferring Pharmaceuticals and Fresenius Kabi and conducts contract research for AM‐Pharma. PP had received honoraria for lectures and participation in advisory boards from Merck Sharp & Dohme, Sanofi, Gilead and Pfizer.

Figures

FIGURE 1
FIGURE 1
Study overview. Patients will be included during a 14‐day inception period chosen by the local investigator. During this period, all acutely admitted adult patients will be screened for inclusion at ICU admission. Eligible patients will be followed daily during their intensive care unit stay (and subsequent stays if readmitted to a participating ICU) until day 90 after which the follow‐up will be completed. Baseline variables are registered at inclusion, and daily registrations are performed for each day in the ICU to a maximum of 90 days. Follow‐up variables are registered at the end of day 90. ECMO, extra corporeal membrane oxygenation; ICU, intensive care unit; SMS‐ICU, simplified mortality score in the intensive care unit
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