Withholding prophylactic platelet transfusion did not meet noninferiority in patients with severe thrombocytopenia<\/p>\n<\/h3>\n
By Elana Gotkine HealthDay Reporter<\/b><\/p>\n
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FRIDAY, May 26, 2023 (HealthDay News) — For patients with severe thrombocytopenia, withholding of prophylactic platelet transfusion before ultrasound-guided placement of a central venous catheter (CVC) results in more CVC-related bleeding events than prophylactic platelet transfusion, according to guidelines published in the May 25 issue of the New England Journal of Medicine<\/em>.<\/p>\n Floor L.F. van Baarle, M.D., from the University of Amsterdam, and colleagues conducted a multicenter, randomized, noninferiority trial involving patients with severe thrombocytopenia (platelet count, 10,000 to 50,000 per mm3<\/sup>) who were treated on the hematology ward or the intensive care unit. Participants were randomly assigned to receive one unit of prophylactic platelet transfusion or no platelet transfusion before ultrasound-guided CVC placement. The per-protocol primary analysis included 373 episodes of CVC placement involving 338 patients. The noninferiority margin was an upper boundary of 3.5 for the 90 percent confidence interval of relative risk.<\/p>\n The researchers found that catheter-related bleeding of grade 2 to 4 occurred in 4.8 and 11.9 percent of patients in the transfusion and no-transfusion groups, respectively (relative risk, 2.45; 90 percent confidence interval, 1.27 to 4.70), and catheter-related bleeding of grade 3 or 4 occurred in 2.1 and 4.9 percent, respectively (relative risk, 2.43; 95 percent confidence interval, 0.75 to 7.93). Overall, there were 15 adverse events reported: 13 were categorized as serious. The net savings were $410 per catheter placement for withholding prophylactic platelet transfusion before CVC placement.<\/p>\n “The noninferiority of withholding transfusion was not shown for the primary outcome of grade 2 to 4 bleeding,” the authors write.<\/p>\n The study was funded by ZonMw.<\/p>\n Abstract\/Full Text (subscription or payment may be required)<\/a><\/p>\n <\/i><\/p>\n