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Fresh frozen plasma (FFP) and platelet transfusions are common interventions in critical care, yet their use varies widely due to uncertainty around when they’re needed. This guideline provides recommendations for the transfusion of FFP or platelets in critically ill patients with thrombocytopenia, with and without active bleeding, who are undergoing invasive procedures.
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In stable nonbleeding critically ill patients with thrombocytopenia and a high risk of spontaneous bleeding, we recommend transfusing platelets if platelet counts fall below 30 to 50 × 109/L.
In critically ill patients with thrombocytopenia and serious active bleeding, we recommend transfusing platelets if platelet counts fall below 50 x 109/L.
In critically ill patients with suspected portal hypertension-related gastrointestinal (GI) bleeding due to thrombocytopenia or coagulopathy who are undergoing GI-endoscopy, we suggest against routine platelet or FFP transfusion.
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Our guidelines are aimed at helping you respond to today’s clinical challenges and improve patient health outcomes. Our panel of experts has developed multimedia content to facilitate adoption of this guideline into your day-to-day practice.
Platelet Transfusion Thresholds for Critical Care Procedures
This flowchart outlines an algorithm for administration of platelets and fresh frozen plasma in patients undergoing common critical care procedures.
Platelet Transfusion Thresholds for Thrombocytopenic Patients
This flowchart outlines an algorithm for administration of platelets and fresh frozen plasma in critically ill patients with thrombocytopenia.
Guideline on Guideline on Platelet and Plasma Transfusion Released by CHEST In a release issued to the media, lead author, Angel Coz Yataco, MD, FCCP, speaks to the importance of this guideline in practice.
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