Prophylactic platelet transfusion prior to central venous catheter placement in patients with thrombocytopenia: study protocol for a randomised controlled trial

Trials
Emma K van de WeerdtStudy collaborative

Abstract

Severe thrombocytopenia should be corrected by prophylactic platelet transfusion prior to central venous catheter (CVC) insertion, according to national and international guidelines. Even though correction is thought to prevent bleeding complications, evidence supporting the routine administration of prophylactic platelets is absent. Furthermore, platelet transfusion bears inherent risk. Since the introduction of ultrasound-guided CVC placement, bleeding complication rates have decreased. The objective of the current trial is, therefore, to demonstrate that omitting prophylactic platelet transfusion prior to CVC placement in severely thrombocytopenic patients is non-inferior compared to prophylactic platelet transfusion. The PACER trial is an investigator-initiated, national, multicentre, single-blinded, randomised controlled, non-inferior, two-arm trial in haematologic and/or intensive care patients with a platelet count of between 10 and 50 × 109/L and an indication for CVC placement. Consecutive patients are randomly assigned to either receive 1 unit of platelet concentrate, or receive no prophylactic platelet transfusion prior to CVC insertion. The primary endpoint is WHO grades 2-4 bleeding. Secondary endpoints are any ble...Continue Reading

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Citations

Sep 13, 2019·Critical Care : the Official Journal of the Critical Care Forum·Sanne de BruinUNKNOWN Cardiovascular Dynamics Section and Transfusion Guideline Task Force of the ESICM
Sep 18, 2018·The Cochrane Database of Systematic Reviews·Lise J EstcourtJanet Birchall
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Nov 19, 2020·Transfusion Medicine·Akshay ShahUNKNOWN ESICM Transfusion Task Force

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