Procedures · Platelets before central line insertion
Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia
| Design | Multicentre randomised non-inferiority trial |
|---|---|
| Treatment | No prophylactic platelet transfusion before central venous catheter placement |
| Control | Prophylactic platelet transfusion |
| Population | 338 patients with a platelet count of 10,000 to 50,000 per cubic millimetre, contributing 373 catheter placements |
| Follow-up | 24 hours after placement |
| Primary endpoint | Catheter-related bleeding of grade 2 to 4 |
| Result | Catheter-related bleeding of grade 2 to 4 occurred in 9 of 188 (4.8%) in the transfusion group and more often in the no-transfusion group, failing to meet the predefined non-inferiority margin. |
| Secondary endpoints | Grade 3 to 4 bleeding, transfusion reactions, cost |
The withholding of prophylactic platelet transfusion before CVC placement in patients with a platelet count of 10,000 to 50,000 per cubic millimeter did not meet the predefined margin for noninferiority.
The trial authors, in the published abstract
A de-implementation trial that failed, which is worth as much as one that succeeds. Prophylactic platelets before central access in this platelet range stay.
van Baarle FLF, van de Weerdt EK, van der Velden WJFM, et al. Platelet Transfusion before CVC Placement in Patients with Thrombocytopenia. N Engl J Med 2023 May 25;388(21):1956-1965.