• Liam J O'Bryan, Jonathan Bedford, Oliver C Redfern, Robert A Hatch, J Duncan Young, and Peter J Watkinson.
• Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom; St Vincent's Hospital Melbourne, University of Melbourne, Fitzroy, Australia. Electronic address: Lobrya.2@gmail.com.
• J Crit Care. 2020 Jun 1; 57: 157-167.

PurposeWe report the use and effect of prophylactic platelet transfusions in critically ill thrombocytopaenic patients, comparing patients with or without bone marrow failure as a cause of thrombocytopaenia.MethodsA retrospective observational study of admissions to three intensive care units (ICU) in the UK. We identified thrombocytopaenic patients who received a platelet transfusion and extracted the platelet count prior and subsequent to platelet transfusion. We grouped patients with or without suspected bone marrow failure, defined by a total white cell count ≤1.0 × 109/L.ResultsOf 11,757 admissions, 399 (3.4%) patients received a platelet transfusion for thrombocytopaenia. The median [IQR] platelet count prior to transfusion in patients without bone marrow failure was 42 [28-64] × 109/L versus 14 [7-24] × 109/L (p < .0001) in those with. The median [IQR] increment in platelets following transfusion was lower in patients with marrow failure (12 [-1-23] × 109/L) compared to those without (18 [5-36] × 109/L) (p = .006).ConclusionsPlatelet transfusions were given at a higher median platelet count than suggested by guidelines. Patients with bone marrow failure were transfused at a lower threshold and experienced a smaller increment in platelet count when compared to patients without marrow failure.Copyright © 2020. Published by Elsevier Inc.

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