Platelet transfusion

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General

Adult Dosing

Thrombocytopenia

  • 1 unit raises count by 50K

Pediatric Dosing

Special Populations

  • Pregnancy Rating:
  • Lactation:
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Indications

Platelet Transfusion Thresholds

most if not all of the following thresholds are based on weak recommendations with low quality evidence[1]

  • <50K if planned lumbar puncture or neurosurgical procedure
  • <20K if planned for central venous catheter placement (preference toward compressible site), or febrile patient
  • <10K in asymptomatic patients (unless due to ITP, TTP, or HIT)

There are no firm recommendations for transfusion thresholds in acute traumatic bleeding but many providers will opt for a goal of 100K, especially if there is evidence of ICH

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life:
  • Metabolism:
  • Excretion:
  • Mechanism of Action:

Comments

  • Transfusion should be type specific because platelets are bathed in plasma
    • Non-type specific platelets can be used but results in higher rate of complications
  • Like pRBCs, platelets can be leukocyte reduced or washed
  • A 6-pack of platelets will raise the count by 40,000 to 60,000[2]

See Also

References

  1. Kaufman, R. et al. Platelet Transfusion: A Clinical Practice Guideline From the AABB. Annals of Internal Medicine. 2015. Vol 162. No. 3 205-214 Full Text
  2. Osterman JL and Arora S. Blood product transfusions and reactions. Emerg Med Clin North Am. 2014; 32(3):727-738.