Blood products use in France: a nationwide cross‐sectional survey

Fillet, Anne‐Marie; Desmarets, Maxime; Assari, S.; Quaranta, Jean-François; François, Anne Isabelle; Pugin, Aurore; Schuhmacher, Anne; Lassale, B.; Monnet, Élisabeth; Cabre, Philippe; Legrand, D.; Binda, Delphine; Djoudi, Rachid

doi:10.1111/trf.13887

Cited by 13 publications

(12 citation statements)

References 8 publications

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“…De Francisci 2004 was the only trial including participants with other diagnoses (adults requiring a liver transplant and children requiring cardiac surgery). Although individuals with haemato-oncological malignancies represent a large proportion of people receiving platelet transfusions, we cannot extrapolate these finding to individuals with other diagnoses (Charlton 2014; Fedele 2016; Fillet 2016; Jones 2013).…”

Section: Discussionmentioning

confidence: 99%

Pathogen-reduced platelets for the prevention of bleeding

Estcourt

Malouf

Hopewell

et al. 2017

Cochrane Database of Systematic Reviews

117

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Background Platelet transfusions are used to prevent and treat bleeding in people who are thrombocytopenic. Despite improvements in donor screening and laboratory testing, a small risk of viral, bacterial, or protozoal contamination of platelets remains. There is also an ongoing risk from newly emerging blood transfusion-transmitted infections for which laboratory tests may not be available at the time of initial outbreak. One solution to reduce the risk of blood transfusion-transmitted infections from platelet transfusion is photochemical pathogen reduction, in which pathogens are either inactivated or significantly depleted in number, thereby reducing the chance of transmission. This process might offer additional benefits, including platelet shelf-life extension, and negate the requirement for gamma-irradiation of platelets. Although current pathogen-reduction technologies have been proven to reduce pathogen load in platelet concentrates, a number of published clinical studies have raised concerns about the effectiveness of pathogen-reduced platelets for post-transfusion platelet count recovery and the prevention of bleeding when compared with standard platelets. This is an update of a Cochrane review first published in 2013. Objectives To assess the effectiveness of pathogen-reduced platelets for the prevention of bleeding in people of any age requiring platelet transfusions. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 9), MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1950), and ongoing trial databases to 24 October 2016. Selection criteria We included RCTs comparing the transfusion of pathogen-reduced platelets with standard platelets, or comparing different types of pathogen-reduced platelets. Data collection and analysis We used the standard methodological procedures expected by Cochrane. Main results We identified five new trials in this update of the review. A total of 15 trials were eligible for inclusion in this review, 12 completed trials (2075 participants) and three ongoing trials. Ten of the 12 completed trials were included in the original review. We did not identify any RCTs comparing the transfusion of one type of pathogen-reduced platelets with another. Nine trials compared Intercept® pathogen-reduced platelets to standard platelets, two trials compared Mirasol® pathogen-reduced platelets to standard platelets; and one trial compared both pathogen-reduced platelets types to standard platelets. Three RCTs were randomised cross-over trials, and nine were parallel-group trials. Of the 2075 participants enrolled in the trials, 1981 participants received at least one platelet transfusion (1662 participants in Intercept® platelet trials and 319 in Mirasol® platelet trials). One trial included children requiring cardiac surgery (16 participants) or adults requiring a liver transplant (28 participants). All of the other...

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Section: Discussionmentioning

confidence: 99%

Pathogen-reduced platelets for the prevention of bleeding

Estcourt

Malouf

Hopewell

et al. 2017

Cochrane Database of Systematic Reviews

117

View full text Add to dashboard Cite

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“…Small studies of a few institutions in both the U.S. and internationally have evaluated transfusions in hospitalized patients . Roubinian et al examined in‐hospital determinants of RBC transfusions using the Kaiser Permanente Health system database using data from 21 hospitals over a four‐year period (2008–2011).…”

Section: Discussionmentioning

confidence: 99%

Factors associated with red blood cell, platelet, and plasma transfusions among inpatient hospitalizations: a nationally representative study in the United States

et al. 2018

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BACKGROUND: Demographic and hospital-level factors associated with red blood cell (RBC), plasma, and platelet transfusions in hospitalized patients across the U.S. are not well characterized. METHODS:We conducted a retrospective analysis of the National Inpatient Sample (2014). The unit of analysis was a hospitalization; sampling weights were applied to generate nationally-representative estimates. The primary outcome was having ≥ 1 RBC transfusion procedure; plasma and platelet transfusions were similarly assessed as secondary outcomes. For each component, factors associated with transfusion were measured using adjusted prevalence ratios (adjPR) and 95% confidence intervals (95% CI) estimated by multivariable Poisson regression. RESULTS:The prevalence of RBC, plasma, and platelet transfusion was 5.8%, 0.9%, and 0.7%, respectively. RBC transfusions were associated with older age (≥ 65 vs. < 18 years; adjPR = 1.80; 95% CI = 1.66-1.96), female sex (adjPR = 1.13; 95% CI = 1.12-1.14), minority race/ethnic status, and hospitalizations in rural hospitals compared to urban teaching hospitals. Prevalence of RBC transfusion was lower among hospitalizations in the Midwest compared to the Northeast (adjPR = 0.73; 95% CI = 0.67-0.80). All components were more likely to be transfused in patients with a primary hematologic diagnosis, patients with a higher number of total diagnoses, patients who experienced a higher number of other procedures, and patients who eventually died in the hospital. In contrast to RBC transfusions, prevalence of platelet transfusion was greater in urban teaching hospitals (vs. rural; adjPR = 1.71; 95% CI = 1.49-1.98) and lower in blacks (vs. whites; adjPR = 0.80; 95% CI = 0.76-0.85). CONCLUSIONS:Nationally, there is heterogeneity in factors associated with transfusion between each blood component, including by hospital type and location. This variability presents patient blood management programs with potential opportunities to reduce transfusions.

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“…Other recent studies demonstrated overtransfusion and administration of double units as common errors [3,4]. Moreover, despite international guidelines are very clear about a sufficient dosage of plasma, underdosage of plasma seems to be an international phenomenon [4,5]. The reason for these observations remains unclear.…”

Section: Introductionmentioning

confidence: 74%

A Third of Perioperative Blood Transfusions in the ICU Does Not Follow Guideline Recommendations - A Retrospective Analysis

Xd¹,

Ghazari²,

Arndt³

et al. 2017

J Intensive Crit Care

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Objective: This study evaluates the relevance of transfusion guidelines for clinical transfusion practice. Background:There is little data available on current practice related to appropriate use of blood products. Recent data suggest incorrect use and over transfusion in Europe. In Germany, indications for transfusion and administration of blood products are strict and detailed. However, in clinical practice, alignment of transfusion guidelines to clinical situations seems to be difficult for physiciansespecially in complex diseases and severity such as in critical care. We hypothesized that significant practice variability exists with regard to guidelines adherence in critically ill.

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Blood products use in France: a nationwide cross‐sectional survey

Abstract: Except for insufficient FFP dosing per patient and limitations on assessment of indications for prescribing, transfusion practices were in agreement with national guidelines.

Cited by 13 publications

References 8 publications

Pathogen-reduced platelets for the prevention of bleeding

Pathogen-reduced platelets for the prevention of bleeding

Factors associated with red blood cell, platelet, and plasma transfusions among inpatient hospitalizations: a nationally representative study in the United States

A Third of Perioperative Blood Transfusions in the ICU Does Not Follow Guideline Recommendations - A Retrospective Analysis

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