Platelet transfusion: a clinical practice guideline from the AABB
Ann. intern. med
; 162(3)Feb . 2015. tab
Article
in English
| BIGG - GRADE guidelines
| ID: biblio-965845
Responsible library:
BR1.1
ABSTRACT
BACKGROUND:
The AABB (formerly, the American Association of Blood Banks) developed this guideline on appropriate use of platelet transfusion in adult patients.METHODS:
These guidelines are based on a systematic review of randomized, clinical trials and observational studies (1900 to September 2014) that reported clinical outcomes on patients receiving prophylactic or therapeutic platelet transfusions. An expert panel reviewed the data and developed recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. RECOMMENDATION 1 The AABB recommends that platelets should be transfused prophylactically to reduce the risk for spontaneous bleeding in hospitalized adult patients with therapy-induced hypoproliferative thrombocytopenia. The AABB recommends transfusing hospitalized adult patients with a platelet count of 10 × 109 cells/L or less to reduce the risk for spontaneous bleeding. The AABB recommends transfusing up to a single apheresis unit or equivalent. Greater doses are not more effective, and lower doses equal to one half of a standard apheresis unit are equally effective. (Grade strong recommendation; moderate-quality evidence). RECOMMENDATION 2 The AABB suggests prophylactic platelet transfusion for patients having elective central venous catheter placement with a platelet count less than 20 × 109 cells/L. (Grade weak recommendation; low-quality evidence). RECOMMENDATION 3 The AABB suggests prophylactic platelet transfusion for patients having elective diagnostic lumbar puncture with a platelet count less than 50 × 109 cells/L. (Grade weak recommendation; very-low-quality evidence). RECOMMENDATION 4 The AABB suggests prophylactic platelet transfusion for patients having major elective nonneuraxial surgery with a platelet count less than 50 × 109 cells/L. (Grade weak recommendation; very-low-quality evidence). RECOMMENDATION 5 The AABB recommends against routine prophylactic platelet transfusion for patients who are nonthrombocytopenic and have cardiac surgery with cardiopulmonary bypass. The AABB suggests platelet transfusion for patients having bypass who exhibit perioperative bleeding with thrombocytopenia and/or evidence of platelet dysfunction. (Grade weak recommendation; very-low-quality evidence). RECOMMENDATION 6 The AABB cannot recommend for or against platelet transfusion for patients receiving antiplatelet therapy who have intracranial hemorrhage (traumatic or spontaneous). (Grade uncertain recommendation; very-low-quality evidence).(AU)
Full text:
Available
Collection:
Tematic databases
Database:
BIGG - GRADE guidelines
Main subject:
Spinal Puncture
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Elective Surgical Procedures
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Platelet Transfusion
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Intracranial Hemorrhages
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Extracorporeal Circulation
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Central Venous Catheters
Type of study:
Controlled clinical trial
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Practice guideline
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Observational study
Language:
English
Journal:
Ann. intern. med
Year:
2015
Document type:
Article
Institution/Affiliation country:
Brigham and Women's Hospital/US
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Canadian Blood Services/CA
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Center for Biologics Evaluation and Research/US
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Children's Hospital Colorado/US
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Children's Hospital of Philadelphia/US
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Children's National Medical Center/US
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Englewood Hospital and Medical Center/US
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Johns Hopkins University/US
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Ottawa Hospital Research Institute/CA
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Surgical and Critical Care Associates/US