Prophylactic versus restrictive platelet transfusion strategy in patients with haematological malignancies in the ICU setting, a propensity-score analysis.
J Crit Care
; 83: 154817, 2024 Oct.
Article
en En
| MEDLINE
| ID: mdl-38805833
ABSTRACT
PURPOSE:
Prophylactic platelet transfusions (PT) aim to reduce bleeding. We assessed whether restrictive PT compared to prophylactic strategy could apply in ICU. MATERIAL ANDMETHODS:
We conducted a retrospective monocentric study including patients >18 yo with haematological malignancy admitted to the ICU with thrombocytopenia <20 G/L between 2018 and 2021. Patients were classified in 2 groups according transfusion strategy applied during the first 3 days prophylactic or restrictive transfusion.RESULTS:
180 patients were included, 87 and 93 in the restrictive and prophylactic groups respectively. After propensity-score analysis, 2 groups of 54 matched patients were analyzed. Restrictive strategy led to a significant reduction in PT with incidence rate for 100-ICU-patients-days of 34.9 and 49.9, incidence rate ratio = 0.699 [0.5-0.9], p = 0.006, representing a 31% decrease. Decreased PT persisted until day 28 with platelet concentrates transfusions-free days at day 28 of 21 [13-25] and 16.5 [10.2-21] in the 2 groups (p = 0.04). Restrictive strategy did not result in higher grade ≥ 2 bleeding. Transfusion efficiency was low with similar number of days with platelet <10 or < 20 G/L regardless of strategy. Platelet transfusion strategy was not associated with 28-day mortality. Platelet nadir <5G/L was associated with day-28 mortality with HR = 1.882 [1.011-3.055], p = 0.046.CONCLUSION:
A restrictive PT strategy appears feasible in the ICU.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Trombocitopenia
/
Transfusión de Plaquetas
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Neoplasias Hematológicas
/
Puntaje de Propensión
/
Unidades de Cuidados Intensivos
Idioma:
En
Revista:
J Crit Care
/
J. crit. care
/
Journal of critical care
Asunto de la revista:
TERAPIA INTENSIVA
Año:
2024
Tipo del documento:
Article