TY - JOUR
T1 - Global transfusion practices in septic patients in the intensive care unit
T2 - insights from the InPUT-study sub-analysis
AU - Kurucz, Vincent C.
AU - Flint, Andrew W.J.
AU - for the InPUT Study Group
AU - Poole, Alexis
AU - Reuland, Merijn C.
AU - van den Oord, Claudia
AU - Schaap, Caroline M.
AU - Bakker, Jan
AU - Cecconi, Maurizio
AU - Feldheiser, Aarne
AU - Meier, Jens
AU - McQuilten, Zoe
AU - Müller, Marcella C.A.
AU - de Bruin, Sanne
AU - Scheeren, Thomas W.L.
AU - Hamid, Tarikul
AU - Aubron, Cécile
AU - Piagnerelli, Michaël
AU - Mahečić, Tina Tomić
AU - Benes, Jan
AU - Russell, Lene
AU - Aguirre-Bermeo, Hernan
AU - Triantafyllopoulou, Konstantina
AU - Chantziara, Vasiliki
AU - Gurjar, Mohan
AU - Myatra, Sheila Nainan
AU - Pota, Vincenzo
AU - Elhadi, Muhammed
AU - Gawda, Ryszard
AU - Mourisco, Mafalda
AU - Lance, Marcus
AU - Neskovic, Vojislava
AU - Podbregar, Matej
AU - Llau, Juan V.
AU - Quintana-Diaz, Manual
AU - Cronhjort, Maria
AU - Pfortmueller, Carmen A.
AU - Yapici, Nihan
AU - Nielsen, Nathan
AU - Shah, Akshay
AU - de Grooth, Harm Jan
AU - Vlaar, Alexander P.J.
AU - Schenk, Jimmy
AU - Raasveld, Senta Jorinde
N1 - Publisher Copyright:
© 2025 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Transfusion practices among intensive care unit (ICU) patients with sepsis vary widely. While restrictive hemoglobin thresholds for red blood cell (RBC) transfusion are well studied, the indications and thresholds for platelet and plasma transfusions remain uncertain. Methods: We performed a sepsis-specific sub-analysis of the International Point Prevalence Study of Intensive Care Unit Transfusion Practices, a prospective, multicenter, observational study capturing all adult ICU admissions during four pre-scheduled weeks between March 2019 and October 2022. Patients admitted with sepsis or septic shock, or who developed sepsis during their ICU stay, were included. We recorded demographics, daily laboratory values, and transfusion triggers. Primary endpoints were the proportions of patients receiving RBCs, platelets, or plasma; secondary endpoints were indications, pre-transfusion thresholds, and blood loss. Results: Among 3643 screened patients, 799 (22%) fulfilled sepsis criteria; within this subgroup, 317 (40%) received at least one blood component. RBCs were transfused in 269 patients (34%), primarily to address anemia or hemodynamic instability, at a mean pre-transfusion hemoglobin of 7.5 ± 1.4 g/dL, consistent with restrictive practice. Platelets were given to 78 patients (10%) for prophylaxis or active bleeding at a median count of 26 × 109 cells/L (interquartile range 16–51 × 109 cells/L). Plasma was administered to 108 patients (14%), half for bleeding control and half for non-bleeding indications.Conclusions: This largest international snapshot of septic ICU transfusion practices confirms adherence to restrictive RBC thresholds but reveals substantial variability in platelet and plasma use. These findings underscore the need for targeted trials to refine transfusion guidelines in sepsis.
AB - Background: Transfusion practices among intensive care unit (ICU) patients with sepsis vary widely. While restrictive hemoglobin thresholds for red blood cell (RBC) transfusion are well studied, the indications and thresholds for platelet and plasma transfusions remain uncertain. Methods: We performed a sepsis-specific sub-analysis of the International Point Prevalence Study of Intensive Care Unit Transfusion Practices, a prospective, multicenter, observational study capturing all adult ICU admissions during four pre-scheduled weeks between March 2019 and October 2022. Patients admitted with sepsis or septic shock, or who developed sepsis during their ICU stay, were included. We recorded demographics, daily laboratory values, and transfusion triggers. Primary endpoints were the proportions of patients receiving RBCs, platelets, or plasma; secondary endpoints were indications, pre-transfusion thresholds, and blood loss. Results: Among 3643 screened patients, 799 (22%) fulfilled sepsis criteria; within this subgroup, 317 (40%) received at least one blood component. RBCs were transfused in 269 patients (34%), primarily to address anemia or hemodynamic instability, at a mean pre-transfusion hemoglobin of 7.5 ± 1.4 g/dL, consistent with restrictive practice. Platelets were given to 78 patients (10%) for prophylaxis or active bleeding at a median count of 26 × 109 cells/L (interquartile range 16–51 × 109 cells/L). Plasma was administered to 108 patients (14%), half for bleeding control and half for non-bleeding indications.Conclusions: This largest international snapshot of septic ICU transfusion practices confirms adherence to restrictive RBC thresholds but reveals substantial variability in platelet and plasma use. These findings underscore the need for targeted trials to refine transfusion guidelines in sepsis.
UR - https://www.scopus.com/pages/publications/105021366172
U2 - 10.1111/trf.18445
DO - 10.1111/trf.18445
M3 - Article
C2 - 41122832
AN - SCOPUS:105021366172
SN - 0041-1132
VL - 65
SP - 2272
EP - 2285
JO - Transfusion
JF - Transfusion
IS - 12
ER -