Grant: Project Grant

Thousands of transfusions of platelets (a blood component that help with clotting) are given in intensive care units (ICUs) every year in Canada. Typically, this occurs when the number of platelets in the blood falls below a certain level. In ICUs, platelet transfusions are mainly given to try and prevent bleeding, for example, before a procedure. However, platelet transfusions also have risks, such as allergic reactions, and may not work as well in critically ill patients. We do not know how far the platelet count should fall before the benefits of giving platelet transfusions outweigh the risks. As a result, the transfusion threshold to decide when platelet transfusions should be given currently varies widely among ICUs. Therefore, we plan to join a large multinational trial of more than 2,550 patients to determine the best threshold below which platelet transfusions should be given to critically ill patients. Patients will be allocated in a randomized process (by chance) to one of five platelet transfusion thresholds. If the platelet count drops below the allocated threshold and an invasive procedure is planned, the patient will be given a platelet transfusion beforehand. We will identify the best transfusion threshold by comparing the outcomes of patients at 90 days. The study will ensure that Canada can participate in an international trial that will have a large and immediate impact on medical practice, as well as wider benefits throughout the health system. Canadian expertise will also use the data from this trial to learn what outcomes patients consider the most important, that will help both this research program and many other investigations that will help patients.