Introduction: Prophylactic platelet transfusions are recommended for central venous catheter placement, including dialysis catheters when platelet counts are below 20,000/mm3. Patients with hematological malignancies have severe thrombocytopenia ( 50 CVCs and encountered patients with severe refractory thrombocytopenia on weekly basis. The majority (74%) chose to transfuse platelets during HDC placement, while 10% transfused to a target threshold beforehand, another 10% transfused prior to placement without specifying a threshold, and 6% proceeded without any transfusion. All respondents opted for ultrasound guided placement; the preferred insertion site was internal jugular vein (63%) followed by femoral vein (25%); 55% chose to administer desmopressin before HDC placement, 25% chose no hemostatic agent (prothrombin complex concentrate, plasma, tranexamic acid). Most (58%) did not seek any consultation; 40% consulted hematology or transfusion medicine. Conclusions: While there was some variability in practice, most providers chose to transfuse one unit of platelets during HDC placement, consistently used ultrasound guidance, and preferred the internal jugular vein insertion site.
Dulu et al. (Sun,) studied this question.