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All About Bleeding

Platelets

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Platelets Therapy

Indications

Platelets are primarily indicated for thrombocytopenia or platelet function defects. Ideally, the platelet count should not be < 50 × 109/l. However, a higher target level (e.g. 100 × 109/l) may be appropriate for patients with multiple trauma.11

Platelets used for transfusion can come from two sources:

  1. Platelet concentrates derived from a unit of whole blood (known as random donor platelet concentrates [RDP])
  2. Apheresis platelets obtained from a single donor by plateletpheresis. Each random platelet donation contains >50 x 109 platelets in approximately 50 ml of plasma. These donations are pooled in the required dose.22

The need for platelet transfusion depends upon many factors and not a single laboratory test. Platelets are used in the treatment or prophylaxis of bleeding during surgery or invasive procedures in patients with clinically significant deficiencies in platelet number or function. They can also be used as part of a standard empirical blood component algorithm. 11, 22

Many guidelines recommended platelets for treating severe bleeding, for example:

'Management of bleeding following major trauma: a European guideline', Rossaint et al. 2010 – platelets should be administered to maintain a platelet count > 50 × 109/l. A platelet count > 100 × 109/l should be maintained in patients with multiple trauma who are severely bleeding or have traumatic brain injury. 20

A platelet count should be carried out around one hour after a transfusion to ensure sufficient levels. However, transfused platelets take up to four hours to become fully functional. An increase of < 20 × 109/l may indicate the presence of HLA antibodies. A lack of response to platelet infusion may also be caused by ABO incompatibility.11


Last Updated: 11/5/2012 12:11 AM
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