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Wu YF, Shen CL, Huang WH, Chu SC, Li CC, Liu CZ, Wang TF. Improving platelet function following prophylactic platelet transfusion in patients with hematological malignancies. Int J Lab Hematol 2024; 46:722-730. [PMID: 38682289 DOI: 10.1111/ijlh.14283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/01/2024] [Indexed: 05/01/2024]
Abstract
INTRODUCTION Platelet transfusion is a standard treatment to prevent bleeding in patients with hematological malignancies. Although transfusions can improve platelet count, their impact on platelet function remains controversial. METHODS We conducted flow cytometry to assess platelet function before and after transfusion and performed subgroup analyses to examine differences based on blood type, corrected count increment (CCI), and platelet microparticles. RESULTS Overall, 50 patients who received prophylactic platelet transfusion were enrolled. CD42b expression increased, whereas CD41 expression decreased after transfusion. Apheresis platelets exhibited the lowest expression of PAC-1 and P-selectin when exposed to agonist stimulations. PAC-1 expression increased under high adenosine diphosphate (ADP) stimulation, while P-selectin expression increased under both high ADP and thrombin receptor-activating peptide stimulation. In the subgroup analysis, patients with a CCI >4500 and those with the same blood types exhibited a more significant increase in PAC-1 and P-selectin expression under agonist stimulation. When comparing apheresis platelets collected on different days, only the percentage of platelet-derived microparticles showed a significant increase. CONCLUSION Prophylactic transfusion improved platelet function. Platelet function significantly improved in patients with a CCI >4500, those with the same blood types as that of apheresis platelets, or those with platelet-derived microparticle levels <4.7%. No significant improvement in platelet function was noted after the transfusion of different blood types with acceptable compatibility or the transfusion of incompatible blood types. Our results suggest that transfusing platelets with the same blood type remains the optimal choice.
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Affiliation(s)
- Yi-Feng Wu
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- College of Medicine, Tzu-Chi University, Hualien, Taiwan
- Ph.D. Program in Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan
| | - Chih-Lung Shen
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wei-Han Huang
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Clinical Pathology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Sung-Chao Chu
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- College of Medicine, Tzu-Chi University, Hualien, Taiwan
| | - Chi-Cheng Li
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Center of Stem Cell & Precision Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Chao-Zong Liu
- Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Tso-Fu Wang
- Department of Hematology and Oncology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- College of Medicine, Tzu-Chi University, Hualien, Taiwan
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2
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van Baarle FLF, van de Weerdt EK, Raasveld SJ, Vlaar APJ, Biemond BJ. Bleeding assessment following central venous catheter placement, a direct comparison of prospective and retrospective analyses. Transfusion 2024; 64:1414-1420. [PMID: 38923611 DOI: 10.1111/trf.17930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Reported bleeding incidences following central venous catheter (CVC) placement highly depend on methods of bleeding assessment. To determine the direction and magnitude of the bias associated with retrospective data collection, we used data from the PACER randomized controlled trial and a previous retrospective cohort study. STUDY DESIGN AND METHODS A patient-level comparison of CVC-related bleeding severity was made among (1) the prospectively collected clinical bleeding assessment of the PACER trial, (2) centralized assessment of CVC insertion site photographs, and (3) retrospective chart review. Interrater reliability for photographic bleeding assessment and retrospective chart review was assessed using Cohen's κ. The magnitude of underreporting of both methods compared to prospective clinical bleeding assessment at different cutoff points of clinically relevant bleeding was assessed using McNemar's test. RESULTS Interrater reliability was acceptable for both methods (κ = 0.583 and κ = 0.481 for photographic assessment and retrospective chart review, respectively). Photographic bleeding assessment led to significant underreporting of bleeding complications at all cutoff points. Retrospective chart review led to significant underreporting of minor bleeding complications, with an odds ratio (95% CI) of 0.17 (0.044-0.51) for the cutoff point grade 1 (i.e., self-limiting or requiring at most 20 min of manual compression) or higher. There was no significant underreporting of major bleeding complications with retrospective chart review. DISCUSSION Centralized photographic bleeding assessment and retrospective chart review lead to biased bleeding assessment compared to prospective clinical bleeding assessment.
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Affiliation(s)
- Floor L F van Baarle
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Emma K van de Weerdt
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - S Jorinde Raasveld
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
| | - Bart J Biemond
- Department of Hematology, Amsterdam UMC Location University of Amsterdam, Amsterdam, the Netherlands
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3
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Christison-Lagay ER, Brown EG, Bruny J, Funaro M, Glick RD, Dasgupta R, Grant CN, Engwall-Gill AJ, Lautz TB, Rothstein D, Walther A, Ehrlich PF, Aldrink JH, Rodeberg D, Baertschiger RM. Central Venous Catheter Consideration in Pediatric Oncology: A Systematic Review and Meta-analysis From the American Pediatric Surgical Association Cancer Committee. J Pediatr Surg 2024; 59:1427-1443. [PMID: 38637207 DOI: 10.1016/j.jpedsurg.2024.03.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/08/2024] [Accepted: 03/20/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Tunneled central venous catheters (CVCs) are the cornerstone of modern oncologic practice. Establishing best practices for catheter management in children with cancer is essential to optimize care, but few guidelines exist to guide placement and management. OBJECTIVES To address four questions: 1) Does catheter composition influence the incidence of complications; 2) Is there a platelet count below which catheter placement poses an increased risk of complications; 3) Is there an absolute neutrophil count (ANC) below which catheter placement poses an increased risk of complications; and 4) Are there best practices for the management of a central line associated bloodstream infection (CLABSI)? METHODS Data Sources: English language articles in Ovid Medline, PubMed, Embase, Web of Science, and Cochrane Databases. STUDY SELECTION Independently performed by 2 reviewers, disagreements resolved by a third reviewer. DATA EXTRACTION Performed by 4 reviewers on forms designed by consensus, quality assessed by GRADE methodology. RESULTS Data were extracted from 110 manuscripts. There was no significant difference in fracture rate, venous thrombosis, catheter occlusion or infection by catheter composition. Thrombocytopenia with minimum thresholds of 30,000-50,000 platelets/mcl was not associated with major hematoma. Limited evidence suggests a platelet count <30,000/mcL was associated with small increased risk of hematoma. While few studies found a significant increase in CLABSI in CVCs placed in neutropenic patients with ANC<500Kcells/dl, meta-analysis suggests a small increase in this population. Catheter removal remains recommended in complicated or persistent infections. Limited evidence supports antibiotic, ethanol, or hydrochloric lock therapy in definitive catheter salvage. No high-quality data were available to answer any of the proposed questions. CONCLUSIONS Although over 15,000 tunneled catheters are placed annually in North America into children with cancer, there is a paucity of evidence to guide practice, suggesting multiple opportunities to improve care. LEVEL OF EVIDENCE III. This study was registered as PROSPERO 2019 CRD42019124077.
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Affiliation(s)
- Emily R Christison-Lagay
- Department of Surgery, Yale New Haven Children's Hospital, Yale School of Medicine, New Haven, CT, USA
| | - Erin G Brown
- Department of Surgery, University of California Davis Children's Hospital, University of California Davis, Sacramento, CA, USA
| | - Jennifer Bruny
- Alaska Pediatric Surgery, Alaska Regional Hospital, Anchorage, AK, USA
| | - Melissa Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, USA
| | - Richard D Glick
- Department of Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA
| | - Roshni Dasgupta
- Department of Surgery, Cincinnati Children's Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Christa N Grant
- Department of Surgery, Maria Fareri Children's Hospital, Westchester Medical Center, New York Medical College, Valhalla, NY, USA
| | | | - Timothy B Lautz
- Department of Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago IL, USA
| | - David Rothstein
- Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - Ashley Walther
- Department of Surgery, Children's Hospital of Los Angeles, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
| | - Peter F Ehrlich
- Department of Surgery, Mott Children's Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - David Rodeberg
- Department of Surgery, Kentucky Children's Hospital, University of Kentucky, Lexington, KY, USA
| | - Reto M Baertschiger
- Department of Surgery, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada; Division of Pediatirc Surgery, Children's Hospital at Dartmouth, Dartmouth Hitchcock Medical Center, Geisel School of Medicine at Dartmouth, Lebaon, NH, USA.
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4
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Poston JN, Andrews J, Arya S, Chou ST, Cohn C, Covington M, Crowe EP, Goel R, Gupta GK, Haspel RL, Hess A, Ipe TS, Jacobson J, Khan J, Murphy M, O'Brien K, Pagano MB, Panigrahi AK, Salazar E, Saifee NH, Stolla M, Zantek ND, Ziman A, Metcalf RA. Current advances in 2024: A critical review of selected topics by the Association for the Advancement of Blood and Biotherapies (AABB) Clinical Transfusion Medicine Committee. Transfusion 2024. [PMID: 39087455 DOI: 10.1111/trf.17975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 07/14/2024] [Indexed: 08/02/2024]
Affiliation(s)
- Jacqueline N Poston
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, Vermont, USA
- Department of Medicine, University of Vermont, Burlington, Vermont, USA
| | - Jennifer Andrews
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Stella T Chou
- Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Claudia Cohn
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Mischa Covington
- Transfusion Medicine, Harvard University, Boston, Massachusetts, USA
| | - Elizabeth P Crowe
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Ruchika Goel
- Department of Pathology, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Internal Medicine, Southern Illinois University, Springfield, Illinois, USA
| | - Gaurav K Gupta
- Transfusion Medicine and Cellular therapy, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Richard L Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Aaron Hess
- Departments of Anesthesiology and Pathology & Laboratory Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Tina S Ipe
- Center for Apheresis and Regenerative Medicine, Little Rock, Arkansas, USA
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jessica Jacobson
- Department of Pathology, NYU Grossman School of Medicine, New York, New York, USA
| | - Jenna Khan
- Department of Pathology, University of Virginia, Charlottesville, Virginia, USA
| | - Mike Murphy
- NHS Blood and Transplant, Oxford University Hospitals NHS Foundation Trust, and the University of Oxford, Oxford, UK
| | - Kerry O'Brien
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Monica B Pagano
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Anil K Panigrahi
- Departments of Anesthesiology and Pathology, Stanford University, Stanford, California, USA
| | - Eric Salazar
- Department of Pathology and Laboratory Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Nabiha H Saifee
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
- Seattle Children's Hospital, Seattle, Washington, USA
| | - Moritz Stolla
- Bloodworks Northwest Research Institute, Seattle, Washington, USA
| | - Nicole D Zantek
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alyssa Ziman
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Ryan A Metcalf
- Department of Pathology, University of Utah, Salt Lake City, Utah, USA
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5
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van den Bosch CH, Grant CN, Brown EG, Morrison ZD, Luques LM, Christison-Lagay ER, Baertschiger RM. Current surgical practice for central venous access to deliver chemotherapy and enteral access for nutritional support in pediatric patients with an oncological diagnosis. Pediatr Blood Cancer 2024:e31206. [PMID: 39030929 DOI: 10.1002/pbc.31206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/01/2024] [Accepted: 07/02/2024] [Indexed: 07/22/2024]
Abstract
Central venous access through tunneled central venous catheters (CVCs) are one of the cornerstones of modern oncologic practice in pediatric patients since CVCs provide a reliable access route for the administration of chemotherapy. Establishing best practices for CVC management in children with cancer is essential to optimize care. This article reviews current best practices, including types of devices, their placement, complications, and long-term outcomes. Additionally, nutrition status and nutritional support are also very important determinants of outcomes and care in pediatric surgical oncology patients. We review current nutritional assessment, support, access for enteral and parenteral nutrition delivery, and their complications, mainly from a surgical perspective. Overall, access surgery, whether for CVCs, or for enteral access can be challenging, and best practice guidelines supported by current though limited evidence are necessary to minimize complications and optimize outcomes.
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Affiliation(s)
| | - Christa N Grant
- Division of Pediatric Surgery, Maria Fareri Children's Hospital, Valhalla, New York, USA
| | - Erin G Brown
- Department of Surgery, University of California Davis Children's Hospital, University of California Davis, Sacramento, California, USA
| | - Zachary D Morrison
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Lisandro M Luques
- Division of Pediatric Surgery, Department of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Israel
| | - Emily R Christison-Lagay
- Department of Surgery, Yale New Haven Children's Hospital, Yale School of Medicine, New Haven, Connecticut, USA
| | - Reto M Baertschiger
- Division of Pediatric Surgery, Department of Surgery, DHMC, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Children's Hospital at Dartmouth, Lebanon, New Hampshire, USA
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6
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Leone M, Nielsen ND, Russell L. Ten tips on sepsis-induced thrombocytopenia. Intensive Care Med 2024; 50:1157-1160. [PMID: 38739278 DOI: 10.1007/s00134-024-07478-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/03/2024] [Indexed: 05/14/2024]
Affiliation(s)
- Marc Leone
- Department of Anaesthesiology and Intensive Care Unit, North Hospital, Assistance Publique Hôpitaux, Service d'Anesthésie Et de Réanimation, Hôpital Nord, Chemin Des Bourrely, Universitaires de Marseille, Aix Marseille University, 13015, Marseille, France.
| | - Nathan D Nielsen
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA
- Section of Transfusion Medicine and Therapeutic Pathology, Department of Pathology, University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Lene Russell
- Department of Intensive Care, Copenhagen University Hospital Gentofte, Hellerup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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7
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Alber S, Tanabe K, Hennigan A, Tregear H, Gilliland S. Year in Review 2023: Noteworthy Literature in Cardiothoracic Critical Care. Semin Cardiothorac Vasc Anesth 2024; 28:66-79. [PMID: 38669120 DOI: 10.1177/10892532241249582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
This article reviews noteworthy investigations and society recommendations published in 2023 relevant to the care of critically ill cardiothoracic surgical patients. We reviewed 3,214 articles to identify 18 publications that add to the existing literature across a variety of topics including resuscitation, nutrition, antibiotic management, extracorporeal membrane oxygenation (ECMO), neurologic care following cardiac arrest, coagulopathy and transfusion, steroids in pulmonary infections, and updated guidelines in the management of acute respiratory distress syndrome (ARDS).
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8
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Kapadia F, Bharadwaj S, Sharma R. Is "Less be More" Still a Valid Concept in Intensive Care? A Review of Critical Care Randomized Clinical Trials from the New England Journal of Medicine. Indian J Crit Care Med 2024; 28:533-551. [PMID: 39130397 PMCID: PMC11310669 DOI: 10.5005/jp-journals-10071-24717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/17/2024] [Indexed: 08/13/2024] Open
Abstract
The concept of "Less is more" has been gaining increasing awareness and acceptance in Critical Care. In 2017, we attempted to systematically answer the question "Can less be more in intensive care" with empirical data. We reviewed all the critical care randomized clinical trials (RCTs) between 1 January 2008 and 5 October 2016 in the New England Journal of Medicine (NEJM). This article attempts to repeat the earlier exercise using data from 5 October 2016 to 31 December 2023. This analysis of critical care RCTs in the NEJM has shown three findings. Approximately three-quarter of RCTs in critical care in the NEJM between 2008 and 2023 failed to show benefit or harm. In the years 2008-2016, patients in the intervention cohort had a higher mortality compared to controls, but in the years 2016-2023, the difference in overall mortality in patients in the intervention and control arms was not statistically significant. Compared to the years 2008-2016, in the years from 2016 to 2023, the number of RCTs showing harm decreased and those showing benefit increased. How to cite this article Kapadia F, Bharadwaj S, Sharma R. Is "Less be More" Still a Valid Concept in Intensive Care? A Review of Critical Care Randomized Clinical Trials from the New England Journal of Medicine. Indian J Crit Care Med 2024;28(6):533-551.
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Affiliation(s)
- Farhad Kapadia
- Department of Intensive Care, PD Hinduja Hospital & Medical Research Center, Mumbai, Maharashtra, India
| | - Shreya Bharadwaj
- Department of Intensive Care, PD Hinduja Hospital & Medical Research Center, Mumbai, Maharashtra, India
| | - Ritika Sharma
- Department of Critical Care, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India
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9
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Lester W, Bent C, Alikhan R, Roberts L, Gordon-Walker T, Trenfield S, White R, Forde C, Arachchillage DJ. A British Society for Haematology guideline on the assessment and management of bleeding risk prior to invasive procedures. Br J Haematol 2024; 204:1697-1713. [PMID: 38517351 DOI: 10.1111/bjh.19360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Will Lester
- Department of Haematology, University Hospitals Birmingham, Birmingham, UK
| | - Clare Bent
- Department of Radiology, University Hospitals Dorset, Dorset, UK
| | - Raza Alikhan
- Department of Haematology, University Hospitals of Cardiff, Cardiff, UK
| | - Lara Roberts
- Department of Haematology, King College London, London, UK
| | - Tim Gordon-Walker
- Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Sarah Trenfield
- Department of Anaesthesia and Critical Care, Royal Brompton Hospital, London, UK
| | - Richard White
- Department of Radiology, Cardiff and Vale UHB, Cardiff, UK
| | - Colm Forde
- Department of Radiology, University Hospitals Birmingham, Birmingham, UK
| | - Deepa J Arachchillage
- Department of Immunology and Inflammation, Centre for Haematology, Imperial College London, London, UK
- Department of Haematology, Imperial College Healthcare NHS Trust, London, UK
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10
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Ajzenberg H, Binhashr MAN, Hewitt MK, Unger M. Critical Care: What You May Have Missed in 2023. Ann Intern Med 2024; 177:S15-S26. [PMID: 38621243 DOI: 10.7326/m24-0565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
Critical care medicine is a specialty that brings together a truly wide spectrum of patient populations, disease states, and treatment methods. This article highlights 10 important pieces of research from 2023 (and 1 from 2022) in critical care. The literature was screened for new evidence relevant to internal medicine physicians and hospitalists whose focus of practice is not critical care but who may be taking care of seriously ill patients. The articles highlight the diverse spectrum of pathology and interplay of various specialties that go into critical care. Topics include transfusion medicine, fluid resuscitation, safe intubation practices and respiratory failure, and the management of acute ischemic stroke. Several trials are groundbreaking, forcing clinicians to reconsider preexisting dogma and likely adopt new treatment strategies.
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Affiliation(s)
- Henry Ajzenberg
- McMaster University, Hamilton, Ontario, Canada (H.A., M.A.N.B., M.K.H.)
| | | | - Mark Keith Hewitt
- McMaster University, Hamilton, Ontario, Canada (H.A., M.A.N.B., M.K.H.)
| | - Michael Unger
- Thomas Jefferson University, Korman Respiratory Institute, Philadelphia, Pennsylvania (M.U.)
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11
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Shah A, Stanworth SJ, Doidge JC, Watkinson PJ. Prophylactic platelet transfusions in critical care: How low can you go? J Intensive Care Soc 2024; 25:123-127. [PMID: 38737301 PMCID: PMC11086719 DOI: 10.1177/17511437231206013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Affiliation(s)
- Akshay Shah
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Simon J Stanworth
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- NHS Blood & Transplant, Oxford, UK
| | - James C Doidge
- Intensive Care National Audit and Research Centre, London, UK
| | - Peter J Watkinson
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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12
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Blumberg N, Asante AA, Nguyen PLT, Heal JM. Platelet Transfusions: The Good, the Bad, and the Ugly. Anesth Analg 2024; 138:921-924. [PMID: 38621279 DOI: 10.1213/ane.0000000000006918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Affiliation(s)
- Neil Blumberg
- From the Transfusion Medicine Division, Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, New York
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13
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Adkins BD, Jacobs JW, Booth GS, Savani BN, Stephens LD. Transfusion Support in Hematopoietic Stem Cell Transplantation: A Contemporary Narrative Review. Clin Hematol Int 2024; 6:128-140. [PMID: 38817704 PMCID: PMC11086996 DOI: 10.46989/001c.94135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 02/05/2024] [Indexed: 06/01/2024] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is a cornerstone of modern medical practice, and can only be performed safely and effectively with appropriate transfusion medicine support. Patients undergoing HSCT often develop therapy-related cytopenia, necessitating differing blood product requirements in the pre-, peri-, and post-transplant periods. Moreover, ensuring optimal management for patients alloimmunized to human leukocyte antigens (HLA) and/or red blood cell (RBC) antigens, as well as for patients receiving ABO-incompatible transplants, requires close collaboration with transfusion medicine and blood bank professionals. Finally, as updated transfusion guidelines and novel blood product modifications emerge, the options available to the transplant practitioner continue to expand. Herein, we detail contemporary blood transfusion and transfusion medicine practices for patients undergoing HSCT.
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Affiliation(s)
- Brian D. Adkins
- PathologyThe University of Texas Southwestern Medical Center
| | | | - Garrett S. Booth
- Pathology, Microbiology, and ImmunologyVanderbilt University Medical Center
| | - Bipin N. Savani
- Internal Medicine, Division of Hematology/ OncologyVanderbilt University Medical Center
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14
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Anthon CT, Pène F, Perner A, Azoulay E, Puxty K, Van De Louw A, Chawla S, Castro P, Povoa P, Coelho L, Metaxa V, Kochanek M, Liebregts T, Kander T, Sivula M, Møller MH, Russell L. Platelet transfusions in adult thrombocytopenic ICU patients: Protocol for a sub-study of the PLOT-ICU cohort. Acta Anaesthesiol Scand 2024; 68:434-440. [PMID: 38115558 DOI: 10.1111/aas.14365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023]
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.
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Affiliation(s)
- Carl Thomas Anthon
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Frédéric Pène
- Médecine Intensive & Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, Paris, France
| | - Anders Perner
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Médecine Intensive & Réanimation, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Elie Azoulay
- Médecine Intensive & Réanimation, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Kathryn Puxty
- Department of Intensive Care, Glasgow Royal Infirmary, Glasgow, UK
| | - Andry Van De Louw
- Division of Pulmonary and Critical Care, Penn State University College of Medicine, Hershey, Pennsylvania, USA
| | - Sanjay Chawla
- Critical Care Medicine Service, Department of Anesthesiology & Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Anesthesiology, Weill Cornell Medical College, New York, New York, USA
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Pedro Povoa
- Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal
- Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal
- Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Luis Coelho
- Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal
- Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal
| | - Victoria Metaxa
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Matthias Kochanek
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Liebregts
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Kander
- Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Mirka Sivula
- Department of Perioperative and Intensive Care Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Coagulation Disorders Unit, Department of Hematology, Comprehensive Cancer Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Morten Hylander Møller
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Russell
- Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Médecine Intensive & Réanimation, Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Université Paris Cité, Paris, France
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15
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Mumoli N, Mereghetti M, Capra R, Pistoia M, Dalla Torre L, Dentali F, Giarretta I. No contraindication to internal jugular central venous catheter insertion in patients at increased risk of bleeding: Results from a prospective observational study in a internal medicine department. J Vasc Access 2024:11297298241227248. [PMID: 38303490 DOI: 10.1177/11297298241227248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
Implantation of centrally inserted central venous catheter (CICC) may be complicated by bleedings particularly in patients with severe coagulopathy or taking antithrombotic drugs. It has been shown that the application of the Italian Group for Venous Access Devices (GAVeCeLT) bundle reduces the incidence of bleeding in patients admitted to intensive care units (ICU), but its effectiveness has never been demonstrated in different contexts. In this study we evaluated the incidence of bleeding after urgent internal jugular CICC (J-CICC) implantation in patients with increased or no risk of bleeding complications when recommended preventive strategies are applied systematically. We included 185 patients admitted to Internal Medicine Units who underwent urgent J-CICC implantation from April 2016 to December 2018. The incidence of major and minor bleeding immediately after the procedure and in the following 30 days was recorded. None of the enrolled patients showed major bleeding. The incidence of minor bleedings was 2.1% (95% IC: 0.03-4.2) with two patients requiring line removal and repositioning (1.1%; 95% IC: -0.45 to 2.6). Bleeds were not correlated with age or sex, although they all occurred in female subjects. The incidence of bleeds was not increased in patients with increased risk of bleeding compared with those without (5.0% vs 1.3%; p = 0.16). The use of anti-thrombotic medications was significantly associated with increased risk of minor bleedings (p = 0.03). In this study we demonstrated that the application of the GAVeCeLT suggested bundle can minimize the number of bleeding complications even in patients hospitalized in Internal Medicine Units. Further data are needed in patients taking antithrombotic drugs who appear to be more prone to minor bleeding, however the benefit of completing the procedure appears to significantly outweigh the risk of mechanical complications.
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Affiliation(s)
- Nicola Mumoli
- Department of Internal Medicine, Ospedale Fornaroli, ASST Ovest Milanese, Magenta, Lombardy, Italy
| | - Marco Mereghetti
- Department of Internal Medicine, Ospedale Fornaroli, ASST Ovest Milanese, Magenta, Lombardy, Italy
| | - Riccardo Capra
- Department of Internal Medicine, Ospedale Fornaroli, ASST Ovest Milanese, Magenta, Lombardy, Italy
| | - Matteo Pistoia
- Department of Internal Medicine, Ospedale Fornaroli, ASST Ovest Milanese, Magenta, Lombardy, Italy
| | - Laura Dalla Torre
- Department of Internal Medicine, Ospedale Fornaroli, ASST Ovest Milanese, Magenta, Lombardy, Italy
| | - Francesco Dentali
- Department of Internal Medicine, Ospedale di Circolo and Fondazione Macchi, ASST Sette Laghi, Varese, Lombardy, Italy
| | - Igor Giarretta
- Department of Internal Medicine, Ospedale di Circolo and Fondazione Macchi, ASST Sette Laghi, Varese, Lombardy, Italy
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16
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Sohail MA, Vachharajani TJ, Lane JE, Huang S, Wang X, Mucha S, Kapoor A, Dugar S, Hanane T. Thromboelastography-Guided Correction of Coagulopathy Before Tunneled Central Venous Access in Critically Ill Patients With Liver Disease: A Propensity Score-Matched Study. Crit Care Explor 2023; 5:e1023. [PMID: 38115819 PMCID: PMC10730036 DOI: 10.1097/cce.0000000000001023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023] Open
Abstract
Importance Optimal blood product transfusion strategies before tunneled central venous catheter (CVC) placement are required in critically ill coagulopathic patients with liver disease to reduce exposure to allogeneic blood products and mitigate bleeding and thrombotic complications. Objectives This study evaluated the safety and efficacy of a thromboelastography-guided transfusion strategy for the correction of coagulopathy in patients with liver disease compared with a conventional transfusion strategy (using international normalized ratio, platelet count, and fibrinogen) before tunneled CVC insertion. Design Setting and Participants A retrospective propensity score-matched single-center cohort study was conducted at a quaternary care academic medical center involving 364 patients with liver disease (cirrhosis and acute liver failure) who underwent tunneled CVC insertion in the ICU. Patients were stratified into two groups based on whether they received blood product transfusions based on a thromboelastography-guided or conventional transfusion strategy. Main Outcomes and Measures Primary outcomes that were evaluated included the volume, units and cost of blood products (fresh frozen plasma, cryoprecipitate, and platelets) when using a thromboelastography-guided or conventional approach to blood transfusions. Secondary outcomes included the frequency of procedure-related bleeding and thrombotic complications. Results The total number of units/volume/cost of fresh frozen plasma (12 U/3,000 mL/$684 vs. 32 U/7,500 mL/$1,824 [p = 0.019]), cryoprecipitate (60 U/1,500 mL/$3,240 vs. 250 U/6,250 mL/$13,500 [p < 0.001]), and platelets (5 U/1,500 mL/$2,610 vs. 13 units/3,900 mL/$6,786 [p = 0.046]) transfused were significantly lower in the thromboelastography-guided transfusion group than in the conventional transfusion group. No differences in the frequency of bleeding/thrombotic events were observed between the two groups. Conclusions and Relevance A thromboelastography-guided transfusion strategy for correction of coagulopathy in critically ill patients with liver disease before tunneled CVC insertion, compared with a conventional transfusion strategy, reduces unnecessary exposure to allogeneic blood products and associated costs without increasing the risk for peri-procedural bleeding and thrombotic complications.
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Affiliation(s)
- Mohammad A Sohail
- Department of Kidney Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Tushar J Vachharajani
- Department of Medicine, John D. Dingell Department of VA Medical Center, Detroit, MI
- Department of Medicine, Wayne State University School of Medicine, Detroit, MI
| | - James E Lane
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Shuaiqi Huang
- Department of Quantitative Health Sciences at Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Xiaofeng Wang
- Department of Quantitative Health Sciences at Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Simon Mucha
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Aanchal Kapoor
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Siddharth Dugar
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH
| | - Tarik Hanane
- Department of Critical Care Medicine, Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH
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17
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Anthon CT, Pène F, Perner A, Azoulay E, Puxty K, Van De Louw A, Barratt-Due A, Chawla S, Castro P, Póvoa P, Coelho L, Metaxa V, Kochanek M, Liebregts T, Kander T, Hästbacka J, Andreasen JB, Péju E, Nielsen LB, Hvas CL, Dufranc E, Canet E, Lundqvist L, Wright CJ, Schmidt J, Uhel F, Ait-Oufella H, Krag M, Cos Badia E, Díaz-Lagares C, Menat S, Voiriot G, Clausen NE, Lorentzen K, Kvåle R, Hildebrandt T, Holten AR, Strand K, Tzalavras A, Bestle MH, Klepstad P, Fernandez S, Vimpere D, Paulino C, Graça C, Lueck C, Juhl CS, Costa C, Bådstøløkken PM, Miranda T, Lêdo LSA, Sousa Torres JC, Granholm A, Møller MH, Russell L. Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU). Intensive Care Med 2023; 49:1327-1338. [PMID: 37812225 PMCID: PMC10622358 DOI: 10.1007/s00134-023-07225-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023]
Abstract
PURPOSE Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients. METHODS We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses. RESULTS We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4-46.1) had thrombocytopenia; 23.4% (20-26) had thrombocytopenia at ICU admission, and 19.8% (17.6-22.2) developed thrombocytopenia during their ICU stay. Absence of acquired immune deficiency syndrome (AIDS), non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19-2.42). CONCLUSION Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.
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Affiliation(s)
- Carl Thomas Anthon
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Frédéric Pène
- Médecine Intensive and Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, Paris, France
| | - Anders Perner
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Médecine Intensive and Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Elie Azoulay
- Médecine Intensive and Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Kathryn Puxty
- Department of Intensive Care, Glasgow Royal Infirmary, Glasgow, UK
| | - Andry Van De Louw
- Division of Pulmonary and Critical Care, Penn State University College of Medicine, Hershey, PA, USA
| | - Andreas Barratt-Due
- Department of Anaesthesia and Intensive Care Medicine, Division of Emergencies and Critical Care, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Sanjay Chawla
- Critical Care Medicine Service, Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Anesthesiology, Weill Cornell Medical College, New York, NY, USA
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Pedro Póvoa
- Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal
- Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal
- Center for Clinical Epidemiology and Research Unit of Clinical Epidemiology, Odense University Hospital, Odense, Denmark
| | - Luis Coelho
- Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal
- Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal
| | - Victoria Metaxa
- Department of Critical Care, King's College Hospital NHS Foundation Trust, London, UK
| | - Matthias Kochanek
- Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tobias Liebregts
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Thomas Kander
- Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Johanna Hästbacka
- Department of Perioperative and Intensive Care Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Anaesthesiology and Intensive Care, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Jo Bønding Andreasen
- Department of Anaesthesia and Intensive Care, Aalborg University Hospital, Aalborg, Denmark
| | - Edwige Péju
- Médecine Intensive and Réanimation, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Cité, Paris, France
| | | | - Christine Lodberg Hvas
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark
| | - Etienne Dufranc
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Emmanuel Canet
- Médecine Intensive Réanimation, CHU de Nantes, Université de Nantes, Nantes, France
| | - Linda Lundqvist
- Department of Intensive and Perioperative Care, Skåne University Hospital, Lund, Sweden
| | | | - Julien Schmidt
- Service de Réanimation Médico-Chirurgicale, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fabrice Uhel
- Médecine Intensive Réanimation, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, DMU ESPRIT, Paris, France
- Institut Necker-Enfants Malades, Université Paris Cité, INSERMUMR-S1151, CNRSUMR-S8253, Paris, France
| | - Hafid Ait-Oufella
- Service de Médecine Intensive-Réanimation, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Mette Krag
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Intensive Care, Holbaek Hospital, Holbaek, Denmark
| | - Elisabet Cos Badia
- Department of Intensive Care, Hospital General Granollers, Barcelona, Spain
| | - Cándido Díaz-Lagares
- Intensive Care Department, Vall d'Hebron Hospital Universitari, Barcelona, Spain
- SODIR Research Group, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Sophie Menat
- Service de Médecine Intensive-Réanimation, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Paris, France
| | - Guillaume Voiriot
- Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Sorbonne Université, Centre de Recherche Saint-Antoine UMRS_938 INSERM, Paris, France
| | - Niels Erikstrup Clausen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kristian Lorentzen
- Department of Intensive Care, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
| | - Reidar Kvåle
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Thomas Hildebrandt
- Department of Intensive Care, Zealand University Hospital - Roskilde, Roskilde, Denmark
| | - Aleksander Rygh Holten
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristian Strand
- Department of Intensive Care, Stavanger University Hospital, Stavanger, Norway
| | - Asterios Tzalavras
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Morten Heiberg Bestle
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Anaesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hilleroed, Denmark
| | - Pål Klepstad
- Department of Intensive Care Medicine, St. Olav's University Hospital, Trondheim, Norway
- Department Circulation and Medical Imaging, Norwegian University of Technology and Science, Trondheim, Norway
| | - Sara Fernandez
- Medical Intensive Care Unit, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain
| | - Damien Vimpere
- Médecine Intensive and Réanimation, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Carolina Paulino
- Nova Medical School, CHRC, New University of Lisbon, Lisbon, Portugal
- Department of Intensive Care, Hospital da Luz Lisboa, Lisbon, Portugal
| | - Carina Graça
- Department of Intensive Care, Hospital Central do Funchal, Funchal, Portugal
| | - Catherina Lueck
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Christian Svendsen Juhl
- Department of Anaesthesiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Carolina Costa
- Intensive Care Unit, Hospital Professor Doutor Fernando Fonseca, EPE, Amadora, Portugal
| | | | - Teresa Miranda
- Department of Intensive Care, Sao Francisco Xavier Hospital, CHLO, Lisbon, Portugal
| | - Lia Susana Aires Lêdo
- Department of Intensive Care Medicine-Unit 2, Hospital Egas Moniz-CHLO, EPE, Lisbon, Portugal
| | | | - Anders Granholm
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Morten Hylander Møller
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Russell
- Department of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
- Médecine Intensive and Réanimation, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France.
- Department of Intensive Care, Copenhagen University Hospital - Gentofte, Hellerup, Denmark.
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18
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Mullier F, Baccini V, Lippi G, Lecompte T. Clinical studies on platelet transfusion: Time to consider methodological issues related to platelet counting. Transfusion 2023; 63:2198-2200. [PMID: 37965704 DOI: 10.1111/trf.17550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 11/16/2023]
Affiliation(s)
- François Mullier
- CHU UCL Namur, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS), Hematology Laboratory, Université catholique de Louvain, Yvoir, Belgium
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique (IREC), Pôle Mont, Yvoir, Belgium
| | - Véronique Baccini
- Laboratoire d'Excellence GR-Ex, Université Paris Cité INSERM, BIGR, Paris, France
- UMR_S1134, Université des Antilles, Guadeloupe, France
| | - Giuseppe Lippi
- Section of Clinical Biochemistry and School of Medicine, University Hospital of Verona, Verona, Italy
| | - Thomas Lecompte
- Department of Pharmacy, Namur Thrombosis and Hemostasis Center (NTHC), Namur Research Institute for Life Sciences (NARILIS), Université de Namur, Namur, Belgium
- Faculté de médecine de Nancy, Université de Lorraine, Nancy, France
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19
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van Baarle FLF, van de Weerdt EK, van der Velden WJFM, Ruiterkamp RA, Tuinman PR, Ypma PF, van den Bergh WM, Demandt AMP, Kerver ED, Jansen AJG, Westerweel PE, Arbous MS, Determann RM, van Mook WNKA, Koeman M, Mäkelburg ABU, van Lienden KP, Vlaar APJ, Biemond BJ. Predictors of the corrected count increment after platelet transfusion, a secondary analysis of the PACER randomized controlled trial. Am J Hematol 2023; 98:E305-E308. [PMID: 37605361 DOI: 10.1002/ajh.27053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/23/2023]
Affiliation(s)
- Floor L F van Baarle
- Department of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Emma K van de Weerdt
- Department of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | | | | | - Pieter R Tuinman
- Department of Intensive Care Medicine, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Paula F Ypma
- Department of Hematology, Haga Ziekenhuis, the Hague, The Netherlands
| | - Walter M van den Bergh
- Department of Critical Care, UMC Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Emile D Kerver
- Department of Oncology, OLVG, Amsterdam, The Netherlands
| | - A J Gerard Jansen
- Department of Hematology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Peter E Westerweel
- Department of Internal Medicine, Albert Schweitzer Ziekenhuis, Dordrecht, The Netherlands
| | - M Sesmu Arbous
- Department of Intensive Care Medicine, Leiden UMC, Leiden, The Netherlands
| | | | | | - Mirelle Koeman
- Department of Intensive Care Medicine, Haga Ziekenhuis, the Hague, The Netherlands
| | - Anja B U Mäkelburg
- Department of Hematology, UMC Groningen, University of Groningen, Groningen, The Netherlands
| | - Krijn P van Lienden
- Department of Interventional Radiology, St Antonius Ziekenhuis, Nieuwegein, The Netherlands
| | - Alexander P J Vlaar
- Department of Intensive Care Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Laboratory of Experimental Intensive Care and Anesthesiology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
| | - Bart J Biemond
- Department of Hematology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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20
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Maier CL, Stanworth SJ, Sola-Visner M, Kor D, Mast AE, Fasano R, Josephson CD, Triulzi DJ, Nellis ME. Prophylactic Platelet Transfusion: Is There Evidence of Benefit, Harm, or No Effect? Transfus Med Rev 2023; 37:150751. [PMID: 37599188 DOI: 10.1016/j.tmrv.2023.150751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023]
Abstract
The optimal use of prophylactic platelet transfusion remains uncertain in a number of clinical scenarios. Platelet count thresholds have been established in patients with hematologic malignancies, yet thresholds backed by scientific data are limited or do not exist for many patient populations. Clinical scenarios involving transfusion thresholds for thrombocytopenic patients with critical illness, need for surgery or invasive procedures, or those involving specials populations like children and neonates, lack clear evidence for discerning favorable outcomes without undue risk related to platelet transfusion. In addition, while prophylactic platelet transfusions are administered with the goal of enhancing hemostasis, increasing evidence supports critical nonhemostatic roles for platelets related to innate and adaptive immunity, inflammation, and angiogenesis, which may impact patient responses and outcomes. Here we review several recent studies conducted in adult or pediatric patients that highlight the limitations in our current understanding of prophylactic platelet transfusion. Together, these studies underscore the need for additional research, especially in the form of robust randomized clinical trials and integrating additional parameters beyond the platelet count. Future research at the basic, translational, and clinical levels will best define the optimal role for prophylactic transfusion across the lifespan and its broader impact on health and disease.
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Affiliation(s)
- Cheryl L Maier
- Center for Transfusion Medicine and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Simon J Stanworth
- NHSBT; Oxford University Hospitals NHS Foundation Trust; Radcliffe Department of Medicine, University of Oxford; Oxford, United Kingdom
| | | | - Daryl Kor
- Department of Anesthesia and Perioperative Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Allan E Mast
- Department of Cell Biology, Neurobiology and Anatomy, Versiti Blood Center of Wisconsin, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ross Fasano
- Center for Transfusion Medicine and Cellular Therapies, Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Cassandra D Josephson
- Department of Oncology, Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Darrell J Triulzi
- Department of Pathology, Division of Transfusion Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marianne E Nellis
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Weill Cornell Medicine, New York, NY, USA
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21
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Stanworth SJ, Shah A, Doidge J, Watkinson P. The ongoing dilemma of prophylactic platelet transfusions pre-procedure and the development of evidence-based recommendations. Transfus Med 2023; 33:428-430. [PMID: 37712550 DOI: 10.1111/tme.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023]
Affiliation(s)
- Simon J Stanworth
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- NHS Blood and Transplant, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Akshay Shah
- Intensive Care National Audit and Research Centre, and London School of Hygiene & Tropical Medicine, London, UK
| | - James Doidge
- Oxford University Hospitals NHS Trust, Oxford, UK
| | - Peter Watkinson
- Intensive Care National Audit and Research Centre, and London School of Hygiene & Tropical Medicine, London, UK
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22
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Reizine F, Le Marec S, Le Meur A, Consigny M, Berteau F, Bodenes L, Geslain M, McQuilten Z, Le Niger C, Huntzinger J, Seguin P, Thibert JB, Simon D, Reignier J, Egreteau PY, Tadié JM, Huet O, Asfar P, Ehrmann S, Aubron C. Prophylactic platelet transfusion response in critically ill patients: a prospective multicentre observational study. Crit Care 2023; 27:373. [PMID: 37759268 PMCID: PMC10537531 DOI: 10.1186/s13054-023-04650-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Response to prophylactic platelet transfusion is suspected to be inconsistent in critically ill patients questioning how to optimize transfusion practices. This study aimed to describe prophylactic platelet transfusion response, to identify factors associated with a suboptimal response, to analyse the correlation between corrected count increment and platelet count increment and to determine the association between poor platelet transfusion response and clinical outcomes. METHODS This prospective multicentre observational study recruited patients who received at least one prophylactic platelet transfusion in one of the nine participating intensive care units for a period up to 16 months. Poor platelet transfusion response was defined as a corrected count increment (CCI) that adjusts for platelet dose and body surface area, less than 7 at 18-24 h after platelet transfusion. Factors associated with poor platelet transfusion response were assessed in a mixed-effect model. Sensitivity analyses were conducted in patients with and without haematology malignancy and chemotherapy. RESULTS Poor platelet transfusion response occurred in 349 of the 472 (73.9%) prophylactic platelet transfusions and in 141/181 (77.9%) patients. The mixed-effect model identified haemoglobin at ICU admission (odds ratio (OR): 0.79 [95% confidence interval (CI) 0.7-0.89]) and body mass index (BMI) (OR: 0.93 [0.89-0.98]) being positively and independently associated with platelet transfusion response, while a haematological malignancy (OR 1.93 [1.09-3.43]), sepsis as primary ICU admission diagnosis (OR: 2.81 [1.57-5.03]), SOFA score (OR 1.10 [1.03; 1.17]) and maximum storage duration of platelet (OR: 1.24 [1.02-1.52]) were independently associated with a suboptimal platelet increment. Clinical outcomes did not differ between groups, nor the requirement for red blood cells. Poor platelet transfusion response was found in 93.5% of patients with haematology malignancy and chemotherapy. CONCLUSIONS In this study of critically ill patients, of whom more than half had bone marrow failure, almost three quarters of prophylactic platelet transfusions led to suboptimal platelet increment measured 18 to 24 h following platelet transfusion. Platelet storage duration was the only factor associated with poor platelet response that may be accessible to intervention. Trial registration in October 2017: ClinicalTrials.gov: NCT03325140.
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Affiliation(s)
- Florian Reizine
- Maladies Infectieuses Et Réanimation Médicale, CHU de Rennes, Rennes, France
- Service de Réanimation Polyvalente, CH de Vannes, Vannes, France
| | - Sarah Le Marec
- Service de Médecine Intensive Réanimation, Université de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Site La Cavale Blanche, Bvd Tanguy Prigent, 29609, Brest Cedex, France
| | - Anthony Le Meur
- Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes, France
| | | | - Florian Berteau
- Service de Réanimation Polyvalente, CH de Morlaix, Morlaix, France
| | - Laetitia Bodenes
- Service de Médecine Intensive Réanimation, Université de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Site La Cavale Blanche, Bvd Tanguy Prigent, 29609, Brest Cedex, France
| | - Marie Geslain
- Département d'anesthésie-Réanimation, Université de Bretagne Occidentale, CHU de Brest, Brest, France
| | - Zoe McQuilten
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australia
| | | | | | - Philippe Seguin
- Service de Réanimation Chirurgicale, CHU de Rennes, Rennes, France
| | | | - David Simon
- Service de Biostatistiques, CHU de Brest, Brest, France
| | - Jean Reignier
- Service de Médecine Intensive Réanimation, CHU de Nantes, Nantes, France
| | | | - Jean-Marc Tadié
- Maladies Infectieuses Et Réanimation Médicale, CHU de Rennes, Rennes, France
| | - Olivier Huet
- Département d'anesthésie-Réanimation, Université de Bretagne Occidentale, CHU de Brest, Brest, France
| | - Pierre Asfar
- Service de Médecine Intensive Réanimation, CHU d'Angers, Angers, France
| | - Stephan Ehrmann
- Médecine Intensive Réanimation, CHRU de Tours INSERM CIC 1415, CRICS-TriggerSEP F-CRIN Research Network, INSERM U1100, Université de Tours FR, Tours, France
| | - Cécile Aubron
- Service de Médecine Intensive Réanimation, Université de Bretagne Occidentale, Centre Hospitalo-Universitaire de Brest, Site La Cavale Blanche, Bvd Tanguy Prigent, 29609, Brest Cedex, France.
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Monash University, Melbourne, Australia.
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23
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Raasveld SJ, van den Oord C, Schenk J, van den Bergh WM, Oude Lansink-Hartgring A, van der Velde F, Maas JJ, van de Berg P, Lorusso R, Delnoij TSR, Dos Reis Miranda D, Scholten E, Taccone FS, Dauwe DF, De Troy E, Hermans G, Pappalardo F, Fominskiy E, Ivancan V, Bojčić R, de Metz J, van den Bogaard B, Donker DW, Meuwese CL, De Bakker M, Reddi B, Henriques JPS, Broman LM, Dongelmans DA, Vlaar APJ. The interaction of thrombocytopenia, hemorrhage, and platelet transfusion in venoarterial extracorporeal membrane oxygenation: a multicenter observational study. Crit Care 2023; 27:321. [PMID: 37605277 PMCID: PMC10441744 DOI: 10.1186/s13054-023-04612-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/14/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Thrombocytopenia, hemorrhage and platelet transfusion are common in patients supported with venoarterial extracorporeal membrane oxygenation (VA ECMO). However, current literature is limited to small single-center experiences with high degrees of heterogeneity. Therefore, we aimed to ascertain in a multicenter study the course and occurrence rate of thrombocytopenia, and to assess the association between thrombocytopenia, hemorrhage and platelet transfusion during VA ECMO. METHODS This was a sub-study of a multicenter (N = 16) study on transfusion practices in patients on VA ECMO, in which a retrospective cohort (Jan-2018-Jul-2019) focusing on platelets was selected. The primary outcome was thrombocytopenia during VA ECMO, defined as mild (100-150·109/L), moderate (50-100·109/L) and severe (< 50·109/L). Secondary outcomes included the occurrence rate of platelet transfusion, and the association between thrombocytopenia, hemorrhage and platelet transfusion, assessed through mixed-effect models. RESULTS Of the 419 patients included, median platelet count at admission was 179·109/L. During VA ECMO, almost all (N = 398, 95%) patients developed a thrombocytopenia, of which a significant part severe (N = 179, 45%). One or more platelet transfusions were administered in 226 patients (54%), whereas 207 patients (49%) suffered a hemorrhagic event during VA ECMO. In non-bleeding patients, still one in three patients received a platelet transfusion. The strongest association to receive a platelet transfusion was found in the presence of severe thrombocytopenia (adjusted OR 31.8, 95% CI 17.9-56.5). After including an interaction term of hemorrhage and thrombocytopenia, this even increased up to an OR of 110 (95% CI 34-360). CONCLUSIONS Thrombocytopenia has a higher occurrence than is currently recognized. Severe thrombocytopenia is strongly associated with platelet transfusion. Future studies should focus on the etiology of severe thrombocytopenia during ECMO, as well as identifying indications and platelet thresholds for transfusion in the absence of bleeding. TRIAL REGISTRATION This study was registered at the Netherlands Trial Registry at February 26th, 2020 with number NL8413 and can currently be found at https://trialsearch.who.int/Trial2.aspx?TrialID=NL8413.
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Affiliation(s)
- Senta Jorinde Raasveld
- Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Claudia van den Oord
- Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Jimmy Schenk
- Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam University Medical Centre, Amsterdam Public Health, University of Amsterdam, Location AMC, Amsterdam, The Netherlands
| | - Walter M van den Bergh
- Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | - Jacinta J Maas
- Adult Intensive Care Unit, Leiden University Medical Center, Leiden, The Netherlands
| | - Pablo van de Berg
- Adult Intensive Care Unit, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Roberto Lorusso
- Cardiothoracic Surgery Department, Heart and Vascular Center, Maastricht University Medical Center, and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands
| | - Thijs S R Delnoij
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Intensive Care, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Dinis Dos Reis Miranda
- Adult Intensive Care Unit, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Erik Scholten
- Department of Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Fabio Silvio Taccone
- Department of Intensive Care, Université Libre de Bruxelles, Hôpital Erasme Bruxelles, Brussels, Belgium
| | - Dieter F Dauwe
- Surgical Intensive Care Unit, Department of Intensive Care Medicine, University Hospital Leuven, Leuven, Belgium
| | - Erwin De Troy
- Surgical Intensive Care Unit, Department of Intensive Care Medicine, University Hospital Leuven, Leuven, Belgium
| | - Greet Hermans
- Medical Intensive Care Unit, Department of General Internal Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
- Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Federico Pappalardo
- Department of CardioThoracic and Vascular Anesthesia and Intensive Care, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Evgeny Fominskiy
- Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Višnja Ivancan
- Department of Anesthesia and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Robert Bojčić
- Department of Anesthesia and Intensive Care, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Jesse de Metz
- Department of Intensive Care, OLVG, Amsterdam, The Netherlands
| | | | - Dirk W Donker
- Intensive Care Center, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
- Cardiovascular and Respiratory Physiology, TechMed Centre, University of Twente, Enschede, The Netherlands
| | - Christiaan L Meuwese
- Adult Intensive Care Unit, Erasmus University Medical Center, Rotterdam, The Netherlands
- Intensive Care Center, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Martin De Bakker
- Department of Critical Care, Royal Adelaide Hospital, Adelaide, Australia
| | - Benjamin Reddi
- Department of Critical Care, Royal Adelaide Hospital, Adelaide, Australia
| | - José P S Henriques
- Department of Cardiology, Amsterdam University Medical Centers, Location Academic Medical Centers, Amsterdam, The Netherlands
| | - Lars Mikael Broman
- ECMO Center Karolinska, Karolinska University Hospital, Stockholm, Sweden
| | - Dave A Dongelmans
- Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Alexander P J Vlaar
- Department of Critical Care, Amsterdam University Medical Centers, Location Academic Medical Centers, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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24
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Gilstad CW. Platelet Transfusion in Patients with Thrombocytopenia. N Engl J Med 2023; 389:479-480. [PMID: 37530839 DOI: 10.1056/nejmc2307377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
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25
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Boulet N, Lefrant JY, Mimoz O, Roger C, Pirracchio R. Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. Anaesth Crit Care Pain Med 2023:101271. [PMID: 37356619 DOI: 10.1016/j.accpm.2023.101271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/20/2023] [Indexed: 06/27/2023]
Affiliation(s)
- Nicolas Boulet
- UR-UM103 IMAGINE, Univ Montpellier, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Montpellier, France.
| | - Jean Yves Lefrant
- UR-UM103 IMAGINE, Univ Montpellier, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Montpellier, France.
| | - Olivier Mimoz
- Services des Urgences Adultes and SAMU 86, Centre Hospitalier Universitaire de Poitiers, Poitiers 86021, France; Université de Poitiers, Inserm U1070, Poitiers, France.
| | - Claire Roger
- UR-UM103 IMAGINE, Univ Montpellier, Division of Anesthesia Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Montpellier, France.
| | - Romain Pirracchio
- Department of Anesthesia and Perioperative Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, United States; Division of Biostatistics, School of Public Health, University of California Berkeley, Berkeley, CA, United States.
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