Platelet Transfusions in the Critically Ill

• Recommendations for the transfusion of platelets in the critically ill patient is primarily extrapolated from the oncology literature; literature that is predominantly observational and expert opinion.
• Nevertheless, indications for the transfusion of platelets in a critically ill ED patient include:
  • active bleeding with a plt count < 50 x 10⁹/L
  • plt count < 10 x 10⁹/L (high risk of spontaneous bleeding)
  • prior to an invasive procedure when the plt count is < 50 x 10⁹/L
• Importantly, the decision to transfuse platelets should also take into account the clinical setting (ie. a uremic patient with active bleeding)

References

Netzer G, Hess JR, Shanholtz C. Use of blood products in the intensive care unit: Concepts and controversies. Contemporary Critical Care June 2010;8(1):1-12.