Multinational transfusion practices and outcomes in haematology patients admitted to the intensive care unit

Schaap, Caroline M. (author), Podbregar, Matej (author), Müller, Marcela C. A. (author)

Background and Objectives: The number of critically ill patients with haematologicalconditions is increasing, yet transfusion practices in this population remain poorlydefined. This study aimed to compare transfusion strategies in critically ill patientswith versus without haematological conditions. Study Design and Methods: This international, prospective observational substudyof the International Point Prevalence Study of Intensive Care Unit [ICU] TransfusionPractices (InPUT) evaluated transfusion use in ICU patients with and without haema-tological conditions, including benign or malignant diseases or a history of stem celltransplantation. Outcomes included use of red blood cells (RBCs), platelets, plasma,haemostatic interventions, transfusion indications and thresholds. Results: Of 3643 ICU patients, 131 (3.6%) had a haematological condition. Thesepatients were more likely to receive RBC (odds ratio [OR] 1.58, 95% confidenceinterval [CI] 1.09–2.29) and platelet transfusions (OR 8.32, 95% CI 5.09–13.6), pri-marily due to low haemoglobin rather than physiological triggers. Platelet thresholdswere lower (median 23 109 /L vs. 64 10 9/L) compared to non-haematologypatients. Both platelet and plasma transfusions were more frequently administeredprophylactically rather than for active bleeding. Haemostatic interventions weremore often used in haematology patients, at higher doses and typically without vis-coelastic testing. Transfused haematology patients had higher 28-day mortality andlonger ICU stays. Conclusion: ICU patients with haematological conditions receive transfusions differ-ently, particularly regarding platelet and plasma use. These findings underscore theneed for prospective studies to define optimal transfusion thresholds in this growingand vulnerable patient population, although the study’s limited sample size and lackof diagnostic granularity may affect interpretation.

• Language: English
• Keywords: transfusion practice, haematological patients, red blood cell
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: Str. 169-179
• Numbering: Vol. 121, iss. 2
• PID: 20.500.12556/RUL-185280
• UDC: 616-083.98
• ISSN on article: 1423-0410
• DOI: 10.1111/vox.70153
• COBISS.SI-ID: 263369987
• Publication date in RUL: 30.07.2026

Record is a part of a journal

• Title: Vox Sanguinis
• Publisher: Wiley, International Society of Blood Transfusion
• ISSN: 1423-0410
• COBISS.SI-ID: 3248148

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