Lowering platelet count threshold to 10,000/microL for peripherally inserted central catheter placement safely conserves blood products.

Despite the low risk of peripherally inserted central catheter (PICC) insertion-related bleeding, the practice of administering prophylactic platelets varies greatly. Limiting unnecessary blood product transfusions reduces transfusion-related adverse events, financial cost, and delays in care. We assessed the impact of lowering prophylactic platelet administration threshold on blood product utilization patterns and bleeding events. This quasi-experimental study was conducted in an urban academic tertiary medical center. The study population included patients with platelet counts >= 10,000/microL and < 50,000/microL undergoing PICC placement in 2018 and 2019 when the minimum platelet thresholds were 50,000/microL and 10,000/microL, respectively. The primary outcome was blood product utilization and the secondary outcome was PICC insertion-related bleeding complications. Thirty-five patients using the 10,000/microL (10 K) platelet threshold and 46 patients using the 50,000/microL (50 K) platelet threshold were enrolled. The 50 K group received more platelets before PICC insertion (0.870 +/- 0.885 and 0.143 +/- 0.430 pools of platelets-per-person, p < 0.001). No patients experienced clinically significant bleeding. Immediately following PICC insertion, minor bleeding occurred in five patients (two [4.3%] and three [8.6%] in the 50 K and 10 K groups, respectively). Bleeding rates between the two cohorts did not differ (p = 0.647). Lowering the minimum platelet threshold from 50,000/microL to 10,000/microL resulted in less prophylactic platelet and total blood product administration with no appreciable difference in PICC insertion-related bleeding. Copyright © 2022. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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