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

Caroline M. Schaap; Laurens A. Oomen; Senta Jorinde Raasveld; Jimmy Schenk; Sanne de Bruin; Merijn C. Reuland; Claudia van den Oord; Jan Bakker; Maurizio Cecconi; Aarne Feldheiser; Jens Meier; Zoe McQuilten; Thomas W.L. Scheeren; Cécile Aubron; Andrew W.J. Flint; Tarikul Hamid; Michaël Piagnerelli; Tina Tomić Mahečić; Jan Benes; Lene Russell; Hernán Patricio Aguirre Bermeo; Konstantina Triantafyllopoulou; Vasiliki Chantziara; Mohan Gurjar; Sheila Nainan Myatra; Vincenzo Pota; Muhammed Elhadi; Ryszard Gawda; Mafalda Mourisco; Marcus Lance; Vojislava Neskovic; Matej Podbregar; Juan V. Llau; Manuel Quintana Díaz; Maria Cronhjort; Carmen A. Pfortmueller; Nihan Yapici; Nathan Nielsen; Harm Jan de Grooth; Alexander P.J. Vlaar; Bart J. Biemond; Akshay Shah; Marcella C. A. Müller

doi:10.1111/vox.70153

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

Caroline M. Schaap (First Author)
, Laurens A. Oomen
, Senta Jorinde Raasveld
, Jimmy Schenk
, Sanne de Bruin
, Merijn C. Reuland
, Claudia van den Oord
, Jan Bakker
, Maurizio Cecconi
, Aarne Feldheiser
, Jens Meier
, Zoe McQuilten
, Thomas W.L. Scheeren
, Cécile Aubron
, Andrew W.J. Flint
, Tarikul Hamid
, Michaël Piagnerelli
, Tina Tomić Mahečić
, Jan Benes
, Lene Russell

Hernán Patricio Aguirre Bermeo, Konstantina Triantafyllopoulou, Vasiliki Chantziara, Mohan Gurjar, Sheila Nainan Myatra, Vincenzo Pota, Muhammed Elhadi, Ryszard Gawda, Mafalda Mourisco, Marcus Lance, Vojislava Neskovic, Matej Podbregar, Juan V. Llau, Manuel Quintana Díaz, Maria Cronhjort, Carmen A. Pfortmueller, Nihan Yapici, Nathan Nielsen, Harm Jan de Grooth, Alexander P.J. Vlaar, Bart J. Biemond, Akshay Shah, Marcella C. A. Müller

Academic Medical Center of University of Amsterdam
Erasmus University Rotterdam
Pontificia Universidad Católica de Chile
IRCCS Istituto Clinico Humanitas - Rozzano (Milano)
Huyssens-Stiftung/Knappschaft
Ruhr University Bochum
Johannes Kepler University Linz
Monash University
University of Groningen
Université de Bretagne Occidentale
Asgar Ali Hospital
Université libre de Bruxelles
University of Zagreb
Charles University
University of Copenhagen
Hospital Monte Sinaí
Interbalkan Medical Center
National and Kapodistrian University of Athens
Sanjay Gandhi Postgraduate Institute of Medical Sciences
Tata Memorial Hospital
University of Campania Luigi Vanvitelli
University of Tripoli
University of Opole
Centro Hospitalar de Entro o Douro e Vouga
Aga Khan University
Military Medical Academy
University of Ljubljana
Hospital Universitario Dr. Peset
Hospital Universitario La Paz
Karolinska Institutet
University of Bern
University of Health Sciences
University of New Mexico
Utrecht University
University of Amsterdam
University of Oxford
Imperial College Healthcare NHS Trust

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

Background and Objectives: The number of critically ill patients with haematological conditions is increasing, yet transfusion practices in this population remain poorly defined. This study aimed to compare transfusion strategies in critically ill patients with versus without haematological conditions. Study Design and Methods: This international, prospective observational substudy of the International Point Prevalence Study of Intensive Care Unit [ICU] Transfusion Practices (InPUT) evaluated transfusion use in ICU patients with and without haematological conditions, including benign or malignant diseases or a history of stem cell transplantation. 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. These patients were more likely to receive RBC (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.09–2.29) and platelet transfusions (OR 8.32, 95% CI 5.09–13.6), primarily due to low haemoglobin rather than physiological triggers. Platelet thresholds were lower (median 23 × 10⁹/L vs. 64 × 10⁹/L) compared to non-haematology patients. Both platelet and plasma transfusions were more frequently administered prophylactically rather than for active bleeding. Haemostatic interventions were more often used in haematology patients, at higher doses and typically without viscoelastic testing. Transfused haematology patients had higher 28-day mortality and longer ICU stays. Conclusion: ICU patients with haematological conditions receive transfusions differently, particularly regarding platelet and plasma use. These findings underscore the need for prospective studies to define optimal transfusion thresholds in this growing and vulnerable patient population, although the study's limited sample size and lack of diagnostic granularity may affect interpretation.

Original language	English
Pages (from-to)	169-179
Number of pages	11
Journal	Vox Sanguinis
Volume	121
Issue number	2
DOIs	https://doi.org/10.1111/vox.70153
State	Published - 24 Nov 2025
Externally published	Yes

Keywords

critically ill
haematological patients
intensive care unit
platelet
red blood cell
transfusion practices

Access to Document

10.1111/vox.70153

Cite this

Schaap, C. M., Oomen, L. A., Raasveld, S. J., Schenk, J., de Bruin, S., Reuland, M. C., van den Oord, C., Bakker, J., Cecconi, M., Feldheiser, A., Meier, J., McQuilten, Z., Scheeren, T. W. L., Aubron, C., Flint, A. W. J., Hamid, T., Piagnerelli, M., Mahečić, T. T., Benes, J., ... Müller, M. C. A. (2025). Multinational transfusion practices and outcomes in haematology patients admitted to the intensive care unit. Vox Sanguinis, 121(2), 169-179. https://doi.org/10.1111/vox.70153

@article{c9f1b591c4ef47c8a7c51b295aa9b65e,

title = "Multinational transfusion practices and outcomes in haematology patients admitted to the intensive care unit",

abstract = "Background and Objectives: The number of critically ill patients with haematological conditions is increasing, yet transfusion practices in this population remain poorly defined. This study aimed to compare transfusion strategies in critically ill patients with versus without haematological conditions. Study Design and Methods: This international, prospective observational substudy of the International Point Prevalence Study of Intensive Care Unit [ICU] Transfusion Practices (InPUT) evaluated transfusion use in ICU patients with and without haematological conditions, including benign or malignant diseases or a history of stem cell transplantation. 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. These patients were more likely to receive RBC (odds ratio [OR] 1.58, 95\% confidence interval [CI] 1.09–2.29) and platelet transfusions (OR 8.32, 95\% CI 5.09–13.6), primarily due to low haemoglobin rather than physiological triggers. Platelet thresholds were lower (median 23 × 109/L vs. 64 × 109/L) compared to non-haematology patients. Both platelet and plasma transfusions were more frequently administered prophylactically rather than for active bleeding. Haemostatic interventions were more often used in haematology patients, at higher doses and typically without viscoelastic testing. Transfused haematology patients had higher 28-day mortality and longer ICU stays. Conclusion: ICU patients with haematological conditions receive transfusions differently, particularly regarding platelet and plasma use. These findings underscore the need for prospective studies to define optimal transfusion thresholds in this growing and vulnerable patient population, although the study's limited sample size and lack of diagnostic granularity may affect interpretation.",

keywords = "critically ill, haematological patients, intensive care unit, platelet, red blood cell, transfusion practices, Critically ill, Haematological patients, Intensive care unit, Female, Hematologic diseases, Humans Intensive care units, Male, Middle aged, Platet transfusion",

author = "Schaap, \{Caroline M.\} and Oomen, \{Laurens A.\} and Raasveld, \{Senta Jorinde\} and Jimmy Schenk and \{de Bruin\}, Sanne and Reuland, \{Merijn C.\} and \{van den Oord\}, Claudia and Jan Bakker and Maurizio Cecconi and Aarne Feldheiser and Jens Meier and Zoe McQuilten and Scheeren, \{Thomas W.L.\} and C{\'e}cile Aubron and Flint, \{Andrew W.J.\} and Tarikul Hamid and Micha{\"e}l Piagnerelli and Mahe{\v c}i{\'c}, \{Tina Tomi{\'c}\} and Jan Benes and Lene Russell and \{Aguirre Bermeo\}, \{Hern{\'a}n Patricio\} and Konstantina Triantafyllopoulou and Vasiliki Chantziara and Mohan Gurjar and Myatra, \{Sheila Nainan\} and Vincenzo Pota and Muhammed Elhadi and Ryszard Gawda and Mafalda Mourisco and Marcus Lance and Vojislava Neskovic and Matej Podbregar and Llau, \{Juan V.\} and \{Quintana D{\'i}az\}, Manuel and Maria Cronhjort and Pfortmueller, \{Carmen A.\} and Nihan Yapici and Nathan Nielsen and \{de Grooth\}, \{Harm Jan\} and Vlaar, \{Alexander P.J.\} and Biemond, \{Bart J.\} and Akshay Shah and M{\"u}ller, \{Marcella C. A.\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Vox Sanguinis published by John Wiley \& Sons Ltd on behalf of International Society of Blood Transfusion.",

year = "2025",

month = nov,

day = "24",

doi = "10.1111/vox.70153",

language = "Ingl{\'e}s",

volume = "121",

pages = "169--179",

journal = "Vox Sanguinis",

issn = "0042-9007",

number = "2",

}

Schaap, CM, Oomen, LA, Raasveld, SJ, Schenk, J, de Bruin, S, Reuland, MC, van den Oord, C, Bakker, J, Cecconi, M, Feldheiser, A, Meier, J, McQuilten, Z, Scheeren, TWL, Aubron, C, Flint, AWJ, Hamid, T, Piagnerelli, M, Mahečić, TT, Benes, J, Russell, L, Aguirre Bermeo, HP, Triantafyllopoulou, K, Chantziara, V, Gurjar, M, Myatra, SN, Pota, V, Elhadi, M, Gawda, R, Mourisco, M, Lance, M, Neskovic, V, Podbregar, M, Llau, JV, Quintana Díaz, M, Cronhjort, M, Pfortmueller, CA, Yapici, N, Nielsen, N, de Grooth, HJ, Vlaar, APJ, Biemond, BJ, Shah, A & Müller, MCA 2025, 'Multinational transfusion practices and outcomes in haematology patients admitted to the intensive care unit', Vox Sanguinis, vol. 121, no. 2, pp. 169-179. https://doi.org/10.1111/vox.70153

TY - JOUR

T1 - Multinational transfusion practices and outcomes in haematology patients admitted to the intensive care unit

AU - Schaap, Caroline M.

AU - Oomen, Laurens A.

AU - Raasveld, Senta Jorinde

AU - Schenk, Jimmy

AU - de Bruin, Sanne

AU - Reuland, Merijn C.

AU - van den Oord, Claudia

AU - Bakker, Jan

AU - Cecconi, Maurizio

AU - Feldheiser, Aarne

AU - Meier, Jens

AU - McQuilten, Zoe

AU - Scheeren, Thomas W.L.

AU - Aubron, Cécile

AU - Flint, Andrew W.J.

AU - Hamid, Tarikul

AU - Piagnerelli, Michaël

AU - Mahečić, Tina Tomić

AU - Benes, Jan

AU - Russell, Lene

AU - Aguirre Bermeo, Hernán Patricio

AU - Triantafyllopoulou, Konstantina

AU - Chantziara, Vasiliki

AU - Gurjar, Mohan

AU - Myatra, Sheila Nainan

AU - Pota, Vincenzo

AU - Elhadi, Muhammed

AU - Gawda, Ryszard

AU - Mourisco, Mafalda

AU - Lance, Marcus

AU - Neskovic, Vojislava

AU - Podbregar, Matej

AU - Llau, Juan V.

AU - Quintana Díaz, Manuel

AU - Cronhjort, Maria

AU - Pfortmueller, Carmen A.

AU - Yapici, Nihan

AU - Nielsen, Nathan

AU - de Grooth, Harm Jan

AU - Vlaar, Alexander P.J.

AU - Biemond, Bart J.

AU - Shah, Akshay

AU - Müller, Marcella C. A.

PY - 2025/11/24

Y1 - 2025/11/24

N2 - Background and Objectives: The number of critically ill patients with haematological conditions is increasing, yet transfusion practices in this population remain poorly defined. This study aimed to compare transfusion strategies in critically ill patients with versus without haematological conditions. Study Design and Methods: This international, prospective observational substudy of the International Point Prevalence Study of Intensive Care Unit [ICU] Transfusion Practices (InPUT) evaluated transfusion use in ICU patients with and without haematological conditions, including benign or malignant diseases or a history of stem cell transplantation. 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. These patients were more likely to receive RBC (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.09–2.29) and platelet transfusions (OR 8.32, 95% CI 5.09–13.6), primarily due to low haemoglobin rather than physiological triggers. Platelet thresholds were lower (median 23 × 109/L vs. 64 × 109/L) compared to non-haematology patients. Both platelet and plasma transfusions were more frequently administered prophylactically rather than for active bleeding. Haemostatic interventions were more often used in haematology patients, at higher doses and typically without viscoelastic testing. Transfused haematology patients had higher 28-day mortality and longer ICU stays. Conclusion: ICU patients with haematological conditions receive transfusions differently, particularly regarding platelet and plasma use. These findings underscore the need for prospective studies to define optimal transfusion thresholds in this growing and vulnerable patient population, although the study's limited sample size and lack of diagnostic granularity may affect interpretation.

AB - Background and Objectives: The number of critically ill patients with haematological conditions is increasing, yet transfusion practices in this population remain poorly defined. This study aimed to compare transfusion strategies in critically ill patients with versus without haematological conditions. Study Design and Methods: This international, prospective observational substudy of the International Point Prevalence Study of Intensive Care Unit [ICU] Transfusion Practices (InPUT) evaluated transfusion use in ICU patients with and without haematological conditions, including benign or malignant diseases or a history of stem cell transplantation. 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. These patients were more likely to receive RBC (odds ratio [OR] 1.58, 95% confidence interval [CI] 1.09–2.29) and platelet transfusions (OR 8.32, 95% CI 5.09–13.6), primarily due to low haemoglobin rather than physiological triggers. Platelet thresholds were lower (median 23 × 109/L vs. 64 × 109/L) compared to non-haematology patients. Both platelet and plasma transfusions were more frequently administered prophylactically rather than for active bleeding. Haemostatic interventions were more often used in haematology patients, at higher doses and typically without viscoelastic testing. Transfused haematology patients had higher 28-day mortality and longer ICU stays. Conclusion: ICU patients with haematological conditions receive transfusions differently, particularly regarding platelet and plasma use. These findings underscore the need for prospective studies to define optimal transfusion thresholds in this growing and vulnerable patient population, although the study's limited sample size and lack of diagnostic granularity may affect interpretation.

KW - critically ill

KW - haematological patients

KW - intensive care unit

KW - platelet

KW - red blood cell

KW - transfusion practices

KW - Critically ill

KW - Haematological patients

KW - Intensive care unit

KW - Female

KW - Hematologic diseases

KW - Humans Intensive care units

KW - Male

KW - Middle aged

KW - Platet transfusion

UR - https://www.scopus.com/pages/publications/105025128005

UR - https://pubmed.ncbi.nlm.nih.gov/41285570/

U2 - 10.1111/vox.70153

DO - 10.1111/vox.70153

M3 - Artículo

C2 - 41285570

AN - SCOPUS:105025128005

SN - 0042-9007

VL - 121

SP - 169

EP - 179

JO - Vox Sanguinis

JF - Vox Sanguinis

IS - 2

ER -

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

Abstract

Keywords

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