Warner MA, et al. – In this study, researchers determined the link between prophylactic platelet transfusion and bleeding complications in severely ill patients. Study participants included 40,693 adults admitted to surgical, medical, or combined medical-surgical ICUs at a single academic institution between January 1, 2009, and December 31, 2013, who had their platelet count measured during admission. A total of 3,227 patients received a platelet transfusion, for which platelet transfusion was prophylactic in nature for 33%. The investigators performed propensity-matched analyses, wherein 994 patients with prophylactic platelet transfusion were matched to those without a transfusion. Significantly higher red blood cell transfusion rates, fewer ICU-free days, fewer hospital-free days, and less improvement in sequential organ failure assessment scores in the subsequent 24 hours, were observed among those receiving prophylactic platelets. These results were reproduced in multiple predefined sensitivity analyses. Overall, no improved clinical outcomes resulted from prophylactic administration of platelets in the critically ill, though residual confounding may exist.