Platelet Transfusion Practices in the PICUs: Multicenter, Observational Study, in Türkiye and Northern Cyprus, 2024
Çağlar Ödek, Fevzi Aydoğdu, Didar Arslan, Gökhan Ocakoğlu, Alper Oğlakçioğlu, Sadik Kaya, Büşra Daştan İnce, Emrah Gün, Ayşe Aşik, Muhterem Duyu, Ayşen Durak Aslan, Tanil Kendirli, Hatice Feray Ari, Alper Köker, Oğuz Dursun, Kübra Cebeci, Pinar Yazici Özkaya, Ebru Azapağasi, Mutlu Uysal Yazici, Erennur Tufan, Damla Pinar Yavaş Kocaoğlu, Selçuk Sinan Çelik, Hasan Ağin, Nihal Akçay, Deniz Güven Karakurt, Ali Korulmaz, Ali Avci, Sinan Yavuz, Faruk Ekinci, Özden Özgür Horoz, Dinçer Yildizdaş, Ömer Özden, Murat Tanyildiz, Betül Demir Akyüz, Muhammed Üdürgücü, Merve Misirlioğlu Çelik, Mehmet Alakaya, Resul Yilmaz, Abdullah Akkuş, Abdullah Yazar, Mebrure Elanur Kortmaz, Hakan Tekgüç, Elif Akman, Neslihan ZenginObjectives:
We aimed to describe the use of platelet transfusions among critically ill children managed in Türkiye in late 2024. Secondarily, we sought to determine these practices in relation to the 2022 Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB) recommendations for critically ill pediatric patients.
Design:
Prospective study (October–December 2024).
Setting:
22 PICUs in Türkiye and Northern Cyprus.
Patients:
Patients of 1 month to 18 years who received at least one platelet transfusion in the PICU.
Interventions:
None
Measurement and Main Results:
Out of 2693 PICU admissions, 200 patients (7.4%) received 577 platelet transfusions. Of the transfusions, 383 of 577 transfusions (66.4%) were for prophylaxis, most frequently for isolated thrombocytopenia (194/383, 50.7%). Regarding the transfusion threshold for prophylaxis, in the 194 cases of isolated thrombocytopenia, the median (interquartile range [IQR]) pretransfusion platelet count was 24 (IQR, 16–38) × 10
9
/L, which differed from the TAXI-CAB consensus statement guidance of less than 10 × 10
9
/L. Platelet transfusion, as opposed to not, was associated with 20-fold greater odds of 28-day mortality (
Conclusions:
Our 2024 national, multicenter PICU study across Türkiye and Northern Cyprus shows that around two-thirds of transfusion episodes were for prophylaxis, and multivariable logistic regression modeling identified patient factors associated with greater odds of 28-day mortality. The median pretransfusion threshold for isolated thrombocytopenia was around 20 × 10 9 /L, which is double the less than 10 × 10 9 /L in the 2022 TAXI-CAB consensus statement. Given the heterogeneity of critically ill patients and practice environments, understanding the reasons behind these practices may help inform future research and consensus recommendations.