Multinational transfusion practices and outcomes in haematology patients admitted to the intensive care unit
Year: 2025
Type: article
Abstract: Background and Objectives The number of critically ill patients with haematological conditions is increasing, yet transfusion practices in this population remain poorly defined. This study aimed to compare transfusion strategies in critically ill patients with versus without haematological conditions. Study Design and Methods This international, prospective observational substudy of the International Point Prevalence Study of Intensive Care Unit [ICU] Transfusion Practices (InPUT) evaluated transfusion use in ICU patients with and without haematological conditions, including benign or malignant diseases or a history of stem cell transplantation. Outcomes included use of red blood cells (RBCs), platelets, plasma, haemostatic interventions, transfusion indications and thresholds. Results Of 3643 ICU patients, 131 (3.6%) had a haematological condition. These patients were more likely to receive RBC (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.09–2.29) and platelet transfusions (OR 8.32, 95% CI 5.09–13.6), primarily due to low haemoglobin rather than physiological triggers. Platelet thresholds were lower (median 23 × 10 9 /L vs. 64 × 10 9 /L) compared to non‐haematology patients. Both platelet and plasma transfusions were more frequently administered prophylactically rather than for active bleeding. Haemostatic interventions were more often used in haematology patients, at higher doses and typically without viscoelastic testing. Transfused haematology patients had higher 28‐day mortality and longer ICU stays. Conclusion ICU patients with haematological conditions receive transfusions differently, particularly regarding platelet and plasma use. These findings underscore the need for prospective studies to define optimal transfusion thresholds in this growing and vulnerable patient population, although the study's limited sample size and lack of diagnostic granularity may affect interpretation.
Source: Vox Sanguinis
DOI: 10.1111/vox.70153
Authors: Caroline M. Schaap, Laurens A. Oomen, Senta Jorinde Raasveld, Jimmy Schenk, Sanne de Bruin, Merijn C. Reuland, Claudia van den Oord, Jan Bakker, Maurizio Cecconi, Aarne Feldheiser, Jens Meier, Zoe McQuilten, Thomas W. L. Scheeren, Cécile Aubron, Andrew W. J. Flint, Tarikul Hamid, Michaël Piagnerelli, Tina Tomić Mahečić, Jan Benes, Lene Russell, Hernan Aguirre‐Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V. Llau, Manual Quintana‐Diaz, Maria Cronhjort, Carmen A. Pfortmueller, Nihan Yapici, Nathan Nielsen, Harm‐Jan de Grooth, Alexander P. J. Vlaar, Bart J. Biemond, Akshay Shah, Marcella C. A. Müller, InPUT Study Group
Institutions: Amsterdam University Medical Centers, Pontificia Universidad Católica de Chile, Erasmus MC, IRCCS Humanitas Research Hospital, Universitätsklinikum Knappschaftskrankenhaus Bochum, Kliniken Essen-Mitte, Johannes Kepler University of Linz, Kepler Universitätsklinikum, Monash University, University Medical Center Groningen, Université de Bretagne Occidentale, Université de Bretagne Occidentale, Asgar Ali Hospital, Université Libre de Bruxelles, University Hospital Centre Zagreb, Charles University, University Hospital Plzen, University of Copenhagen, Copenhagen University Hospital, Gentofte Hospital, Rigshospitalet, Interbalkan Medical Center, National and Kapodistrian University of Athens, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Homi Bhabha National Institute, Tata Memorial Hospital, University of Campania "Luigi Vanvitelli", University of Tripoli, University of Opole, Unidade Local de Saúde de Entre Douro e Vouga, Aga Khan University Hospital Nairobi, Aga Khan University Nairobi, Military Medical Academy, University of Ljubljana, Hospital Universitario Doctor Peset, Hospital Universitario La Paz, Karolinska Institutet, Stockholm South General Hospital, University of Bern, University Hospital of Bern, Sağlık Bilimleri Üniversitesi, University of New Mexico, Utrecht University, University Medical Center Utrecht, Amsterdam UMC Location University of Amsterdam, University of Amsterdam, Imperial College Healthcare NHS Trust, Hammersmith Hospital, University of Oxford
Language: English
Subfield: Biochemistry
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,150
OpenAlex ID: W4416679586