TY - JOUR
T1 - Refrigerated platelets for the treatment of acute bleeding
T2 - A review of the literature and reexamination of current standards
AU - Pidcoke, Heather F.
AU - Spinella, Philip C.
AU - Ramasubramanian, Anand K.
AU - Strandenes, Geir
AU - Hervig, Tor
AU - Ness, Paul M.
AU - Cap, Andrew P.
PY - 2014/5
Y1 - 2014/5
N2 - This review is a synopsis of the decisions that shaped global policy on platelet (PLT) storage temperature and a focused appraisal of the literature on which those discussions were based. We hypothesize that choices were centered on optimization of preventive PLT transfusion strategies, possibly to the detriment of the therapeutic needs of acutely bleeding patients. Refrigerated PLTs are a better hemostatic product, and they are safer in that they are less prone to bacterial contamination. They were abandoned during the 1970s because of the belief that clinically effective PLTs should both be hemostatically functional and survive in circulation for several days as indicated for prophylactic transfusion; however, clinical practice may be changing. Data from two randomized controlled trials bring into question the concept that stable autologous stem cell transplant patients with hypoproliferative thrombocytopenia should continue to receive prophylactic transfusions. At the same time, new findings regarding the efficacy of cold PLTs and their potential role in treating acute bleeding have revived the debate regarding optimal PLT storage temperature. In summary, a "one-size-fits-all" strategy for PLT storage may not be adequate, and a reexamination of whether cold-stored PLTs should be offered as a widely available therapeutic product may be indicated.
AB - This review is a synopsis of the decisions that shaped global policy on platelet (PLT) storage temperature and a focused appraisal of the literature on which those discussions were based. We hypothesize that choices were centered on optimization of preventive PLT transfusion strategies, possibly to the detriment of the therapeutic needs of acutely bleeding patients. Refrigerated PLTs are a better hemostatic product, and they are safer in that they are less prone to bacterial contamination. They were abandoned during the 1970s because of the belief that clinically effective PLTs should both be hemostatically functional and survive in circulation for several days as indicated for prophylactic transfusion; however, clinical practice may be changing. Data from two randomized controlled trials bring into question the concept that stable autologous stem cell transplant patients with hypoproliferative thrombocytopenia should continue to receive prophylactic transfusions. At the same time, new findings regarding the efficacy of cold PLTs and their potential role in treating acute bleeding have revived the debate regarding optimal PLT storage temperature. In summary, a "one-size-fits-all" strategy for PLT storage may not be adequate, and a reexamination of whether cold-stored PLTs should be offered as a widely available therapeutic product may be indicated.
KW - Cold platelets
KW - acute hemorrhage
KW - damage control resuscitation
KW - hypoproliferative thrombocytopenia
KW - massive transfusion protocols
KW - platelet storage temperature
KW - severe hemorrhage
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=84899486915&partnerID=8YFLogxK
U2 - 10.1097/SHK.0000000000000078
DO - 10.1097/SHK.0000000000000078
M3 - Article
C2 - 24662779
AN - SCOPUS:84899486915
SN - 1073-2322
VL - 41
SP - 51
EP - 53
JO - Shock
JF - Shock
IS - SUPPL. 1
ER -