Transfusion plaquettaire en réanimation

Platelet transfusion in intensive care

Abstract

Platelet transfusion is given in thrombocytopenic patients mainly to prevent bleeding, prior or not to invasive procedure, or to treat bleeding in patients with or without thrombocytopenia. Thrombocytopenia in critically ill patients results from various mechanisms that can be basically categorized into hypoproliferative and peripheral, depending on patients’ comorbidities and on the acute situation. Platelet transfusion policies in intensive care unit (ICU) are not based on robust evidence and are mainly transposed from non-ICU settings. This narrative review describes first the main mechanisms of thrombocytopenia in ICU patients and the bleeding risk assessment in this population, that both need to be integrated in the platelet transfusion decision making process. Then, platelet products, both available and under development, are presented, and the main platelet transfusion complications that clinicians need to be aware of when deciding to administer platelets are described.