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Old 07-18-2011
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Blood Platelet Level to start platelet transfusion?

Is there a specific platelet level that one should start packed platelet transfusion?? It seems every question I come across in states something different.
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Old 07-18-2011
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10000 as per WHO recommendation for dengue.but for almost all conditions gum bleeding,frank hematuria or any signs of microcapillary instability with platelet count of even 50000 we tranfuse.
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Old 07-18-2011
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if its <20000, you transfuse definitely. If b/w 20000-50000, you transfuse if u are actively bleeding (symptomatic).
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i know one exception to this is for ITP, you give steroids even if there is petechia/epistaxis until platelets drop to 20000, then you do splenectomy/transfuse


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if its <20000, you transfuse definitely. If b/w 20000-50000, you transfuse if u are actively bleeding (symptomatic).
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Old 07-18-2011
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Quote:
Originally Posted by Androide89 View Post
Is there a specific platelet level that one should start packed platelet transfusion?? It seems every question I come across in states something different.
I think there is no clear cur off, u have to take into consideration the pt's symptoms, risks & cause of thrombocytopenia & then decide accordingly.

Regarding a routine surgical patient (preop/postop) the cut off value is 50,000 & for some cases of Eye & Neurosurgery, sometime its recommended that platelet level should be more than 100,000.

Pts usually do not bleed spontaneously unless their platelets counts fall less then 10,000.

But the cut of limit for other patients is not clear.
If some one is symptomatic then that would be a an indication to transfuse.

It would also depend upon the etiology of the thrombocytopenia, for example if someone has a platelet defect & are actively bleeding then we may give them Platelet transfusion regardless of their platelet count.
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it depends,
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UpToDate provide a more clear cut recommendation although this is not based on very high level of evidence but we can at least have these in mind
Platelets should be transfused under the following conditions
  • Bleeding patients Patients with severe hypoproductive thrombocytopenia and bleeding require platelet transfusion. We suggest such transfusion in any bleeding patient with a platelet count below 50,000/microL
  • Invasive procedures In patients with hypoproductive thrombocytopenia undergoing an invasive procedure, we suggest platelet transfusion for a platelet count below 50,000/microL
Minor procedures (eg, central line placement) most likely can be safely performed at lower platelet counts, while in other cases (eg, neurosurgical procedures, spinal anesthesia), the neurosurgeon or anesthesiologist may require preprocedural platelet counts as high as 100,000/microL.
  • Febrile non-bleeding patients In patients with hypoproductive thrombocytopenia who are not bleeding and are febrile, we suggest platelet transfusion when the platelet count is less than 20,000/microL
  • Afebrile patient without bleeding In patients with hypoproductive thrombocytopenia who are not bleeding and are afebrile, we recommend platelet transfusion when the platelet count is less than 10,000/microL Transfusion at lower platelet count levels (eg, when the platelet count is ≤5000/microL) may be considered in otherwise stable, non-bleeding patients.
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Old 07-18-2011
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I agree with ' cool_atomic'
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