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Fresh frozen plasma (FFP) and platelet transfusions are common interventions in critical care, yet their use varies widely due to uncertainty around when they’re needed. This guideline provides recommendations for the transfusion of FFP or platelets in critically ill patients with thrombocytopenia, with and without active bleeding, who are undergoing invasive procedures.
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In stable nonbleeding critically ill patients with thrombocytopenia and a high risk of spontaneous bleeding, we recommend transfusing platelets if platelet counts fall below 30 to 50 × 109/L.
In critically ill patients with thrombocytopenia and serious active bleeding, we recommend transfusing platelets if platelet counts fall below 50 x 109/L.
In critically ill patients with suspected portal hypertension-related gastrointestinal (GI) bleeding due to thrombocytopenia or coagulopathy who are undergoing GI-endoscopy, we suggest against routine platelet or FFP transfusion.
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