Platelet transfusion trigger in the intensive care unit

© Springer International Publishing Switzerland 2015. Acquired platelet abnormalities may result from a change in platelet number or platelet function. Thrombocytopenia is common in critically unwell patients, and causes are often multifactorial in nature. Up to one quarter of critically ill patients receive a platelet transfusion, usually to prevent rather than to treat bleeding. There are several guidelines to help guide clinicians make platelet transfusion decisions, but little is currently understood about the association between absolute platelet number, in vivo platelet function and overall bleeding risk. This chapter summarises the current and limited evidence for prophylactic platelet transfusion triggers in different clinical scenarios in critically unwell adults, children and neonates. Platelet transfusions are biological agents and not without risk. A main treatment for acquired platelet abnormalities remains management of the underlying disorder.