Cold versus room temperature storage of platelets for haemorrhage control

Abstract

Objectives: Platelets play an important role in controlling blood loss. The objective of this dissertation is to review the effectiveness of cold stored platelets against storage at room temperature to control haemorrhage. Research Question: Are cold storage platelets more effective than room temperature storage in controlling haemorrhage? PICO Elements: (P) persons receiving platelets, (I) cold stored compared to (C) room temperature stored to (O) control haemorrhage. Method: The search for evidence from HyDi, EBSCOHost, CINAHL databases, Transfusion evidence library and handsearching was conducted to evaluate how platelets stored at 4 ˚C compare with storage at 22 ˚C to control haemorrhage in patients. The search included variation of terms for cold-storage platelets and haemorrhage or blood loss. The articles retrieved included five random controlled trials. The appraisal tool used was the ‘Critical Appraisal Skills Programme’ known as CASP. Inclusion and Exclusion Criteria: Studies that were in languages other than English, conducted on animals, involved cryopreservation, and freezing of platelet concentrates, and whole blood transfusions were excluded. The Implications and Recommendations: This study is significant to better utilise the platelets resources with the possibility of maintaining a dual platelet inventory, platelets stored at 22˚C for the treatment and prevention of thrombocytopenia, whereas platelets stored at 4˚C can be used for haemostatic emergency as is the case of actively bleeding patients. Results: The review demonstrates that cold-stored platelets are as effective as platelets stored at room temperature in treating haemorrhage in the absence of platelet disorders. Cold-stored platelets were found to be effective up to 10 to 14 days ensuring a prolongation of storage. Conclusion: The management of a dual inventory requires careful planning with adequate training, consultation with clinical and laboratory staff, and patient follow-ups. It is recommended that further clinical studies are conducted to answer whether cold storage platelets are more effective than room storage platelets in controlling haemorrhage.