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Journal of Intensive Care Medicine
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The Practice of Platelet Transfusion in the Intensive Care Unit

Salam S. Salman, MD

Pulmonary and Critical Care Medicine, Graduate Hospital, Philadelphia, PA

Evans R. Fernández Pérez, MD

Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN, Fernandez.evans{at}mayo.edu

James R. Stubbs, MD

Transfusion Medicine, Mayo Clinic College of Medicine, Rochester, MN

Ognjen Gajic, MD

Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN

The practice of platelet transfusion in the intensive care unit varies, and liberal use may not be associated with improved outcome. This study reviewed the medical records of 117 patients with moderate-to-severe thrombocytopenia and without active bleeding who were admitted to intensive care unit beds during a 6-month period. The primary outcome measures were new bleeding episodes and platelet transfusion complications. Ninety (77%) received a platelet transfusion. Significant new bleeding developed in 1 patient who received a transfusion. Six patients (8%) developed transfusion complications: 2 transfusion-related acute lung injury, 2 allergic, and 2 febrile reactions. Patients who did not receive platelet transfusion had a higher severity of illness than transfused patients. Predictors of platelet transfusion were platelet count and postoperative status, but not invasive procedure. The practice of platelet transfusion in critically ill patients with thrombocytopenia varies. Prospective studies evaluating restrictive versus liberal platelet transfusion strategies are warranted.

Key Words: platelets • intensive care unit • thrombocytopenia

Journal of Intensive Care Medicine, Vol. 22, No. 2, 105-110 (2007)
DOI: 10.1177/0885066606297969
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