Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort

Carl Thomas Anthon¹, Frédéric Pène², Anders Perner^{1

3

4}, Elie Azoulay⁴, Kathryn Puxty⁵, Andry Van De Louw⁶, Sanjay Chawla^{7

8}, Pedro Castro⁹, Pedro Povoa^{10

11

12}, Luis Coelho^{10

11}, Victoria Metaxa¹³, Matthias Kochanek¹⁴, Tobias Liebregts¹⁵, Thomas Kander^{16

17}, Mirka Sivula^{18

19}, Morten Hylander Møller^{1

3}, Lene Russell^{1

3

4}

Affiliations

¹ Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
² Médecine Intensive & Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, Paris, France.
³ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁴ Médecine Intensive & Réanimation, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
⁵ Department of Intensive Care, Glasgow Royal Infirmary, Glasgow, UK.
⁶ Division of Pulmonary and Critical Care, Penn State University College of Medicine, Hershey, Pennsylvania, USA.
⁷ Critical Care Medicine Service, Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁸ Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA.
⁹ Medical Intensive Care Unit, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
¹⁰ Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal.
¹¹ Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
¹² Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
¹³ Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
¹⁴ Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
¹⁵ Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
¹⁶ Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden.
¹⁷ Department of Clinical Sciences, Lund University, Lund, Sweden.
¹⁸ Department of Perioperative and Intensive Care Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
¹⁹ Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

PMID: 38115558
PMCID: PMC11638841
DOI: 10.1111/aas.14365

Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort

Carl Thomas Anthon et al. Acta Anaesthesiol Scand. 2024 Mar.

. 2024 Mar;68(3):434-440.

doi: 10.1111/aas.14365. Epub 2023 Dec 19.

Authors

Affiliations

¹ Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.
² Médecine Intensive & Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, Paris, France.
³ Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
⁴ Médecine Intensive & Réanimation, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France.
⁵ Department of Intensive Care, Glasgow Royal Infirmary, Glasgow, UK.
⁶ Division of Pulmonary and Critical Care, Penn State University College of Medicine, Hershey, Pennsylvania, USA.
⁷ Critical Care Medicine Service, Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁸ Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA.
⁹ Medical Intensive Care Unit, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain.
¹⁰ Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal.
¹¹ Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal.
¹² Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, Odense University Hospital, Odense, Denmark.
¹³ Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK.
¹⁴ Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
¹⁵ Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
¹⁶ Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden.
¹⁷ Department of Clinical Sciences, Lund University, Lund, Sweden.
¹⁸ Department of Perioperative and Intensive Care Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
¹⁹ Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

PMID: 38115558
PMCID: PMC11638841
DOI: 10.1111/aas.14365

Abstract

Introduction: Platelet transfusions are frequently used in intensive care unit (ICU) patients, but contemporary epidemiological data are sparse. We aim to present contemporary international data on the use of platelet transfusions in adult ICU patients with thrombocytopenia.

Methods: This is a protocol and statistical analysis plan for a post hoc sub-study of 504 thrombocytopenic patients from the 'Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)'. The primary outcome will be the number of patients receiving platelet transfusion in the ICU reported according to the type of product received (apheresis-derived versus pooled whole-blood-derived transfusions). Secondary platelet transfusion outcomes will include platelet transfusion volumes; timing of platelet transfusion; approach to platelet transfusion dosing (fixed dosing versus weight-based dosing) and platelet count increments for prophylactic transfusions. Secondary clinical outcomes will include the number of patients receiving red blood cell- and plasma transfusions during ICU stay; the number of patients who bled in the ICU, the number of patients who had a new thrombosis in the ICU, and the number of patients who died. The duration of follow-up was 90 days. Baseline characteristics and secondary clinical outcomes will be stratified according to platelet transfusion status in the ICU and severity of thrombocytopenia. Data will be presented descriptively.

Conclusions: The outlined study will provide detailed epidemiological data on the use of platelet transfusions in adult ICU patients with thrombocytopenia using data from the large international PLOT-ICU cohort study. The findings will inform the design of future randomised trials evaluating platelet transfusions in ICU patients.

Keywords: critical care; intensive care unit; platelet transfusions; thrombocytopenia.

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Conflict of interest statement

CONFLICT OF INTEREST

The Department of Intensive Care at Rigshospitalet (CTA, AP, MHM, LR) has received funding for other research projects from Sygeforsikringen ‘danmark’ and the Novo Nordisk Foundation. FP has received honoraria for consulting and lectures from Gilead and an institutional grant from Alexion Pharma. AP has received honoraria from Novartis for participation in an advisory board. EA has received research grants from MSD Avenir and Alexion and honoraria for lectures from Alexion, Sanofi and Pfizer. AVDL has received honoraria from Sanofi for participation in an advisory board. PC has received consulting fees from Sanofi, Gilead, Alexion and Janssen and honoraria for lectures from Merck Sharp & Dohme, Gilead, Alexion and Pfizer. PP has received consulting fees from Sanofi and Gilead and honoraria from Merck Sharp & Dohme, Gilead, Mundipharma and Pfizer for academic and educational work. MS has received honoraria for lectures and participating in an advisory board from CSL Behring, Alexion, AstraZeneca Rare Disease and Takeda. None of these have any relation to the current work.

References

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1. Anthon CT, Pène F, Perner A, et al. Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU). Intensive Care Med. 2023;49:1327–1338. doi:10.1007/s00134-023-07225-2 - DOI - PMC - PubMed
1. Jonsson AB, Rygård SL, Hildebrandt T, Perner A, Møller MH, Russell L. Thrombocytopenia in intensive care unit patients: a scoping review. Acta Anaesthesiol Scand. 2021;65:2–14. doi:10.1111/AAS.13699 - DOI - PubMed

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Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort

Affiliations

Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources