Sepsis
Conditions
Interventions
High threshold:Prophylactic platelet transfusion is administered when the platelet count reaches the threshold (also called the trigger value or indication) of <=50×10^9/L.
Low threshold:Prophylactic platelet transfusion is administered when the platelet count reaches the threshold (also called the trigger value or indication) of <=20×10^9/L.
(Exploration of red blood cell transfusion markers based on proteomics) Control group:None
(Exploration of red blood cell transfusion markers based on proteomics) Sepsis group Non-transfusion group:None
(Proteomics-based exploration of red blood cell transfusion markers) Sepsis group with intermediate transfusion threshold (Hb 7.0-9.0 g/dL):None
(Exploration of red blood cell transfusion markers based on proteomics) Sepsis group with intermediate transfusion threshold (Hb < 7.0 g/dL):None
(Translational basic research) control group:None
(Translational Basic Research) Low Threshold Group:None
(Translational Basic Research) High Threshold Group:None
Sponsors
The Third People's Hospital of Chengdu
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Exploration of Red Blood Cell Transfusion Markers Based on ProteomicsPatients:aged >=18 years, meeting Sepsis-3 diagnosis, in medical, surgical, and cardiac surgery departments with Hb levels greater than 9 g/dL, Hb =18 years; (2) Admitted to the Intensive Care Unit (ICU); (3) Diagnosed with sepsis (according to Sepsis-3 criteria: presence of confirmed or suspected infection, and an acute change in total SOFA score >=2 points), and platelet count =18 years, meeting Sepsis-3 diagnosis in medical or emergency ICU, with platelet count =18 years; (3) Platelet count <=50×10^9/L within the past 6 hours; (4) Meeting Sepsis-3.0 diagnostic criteria; (5) Informed consent signed by a legally authorized representative.
Exclusion criteria
Exclusion criteria: Proteomics-based exploration of red blood cell transfusion markers Patients with massive bleeding, patients with known chronic blood system diseases, cancer patients undergoing chemotherapy or radiotherapy, patients with terminal diseases who have given up active treatment, patients with severe liver failure, patients who have received blood transfusion treatment in the recent period (3 months), and pregnant women. Retrospective study 1. Patients who died within 2 days after admission to the ICU or were discharged voluntarily without following the doctor's advice; 2. Pregnant or breastfeeding; 3. Patients with active bleeding or postoperative status; 4. Patients receiving dialysis, extracorporeal circulation or extracorporeal membrane oxygenation (ECMO); 5. Patients with a history of organ transplantation or receiving immunosuppressive therapy; 6. Patients using antiplatelet drugs; 7. Patients with non-sepsis-related thrombocytopenia, including: immune thrombocytopenia (patients who received platelet transfusion within 3 weeks before enrollment should be tested for platelet antibodies), hereditary thrombocytopenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, drug-related thrombocytopenia (such as ITP, HIT, PTP), and malignancy-related thrombocytopenia. Translational basic research 1. Patients who died within 2 days after admission to the ICU or were discharged voluntarily without following the doctor's advice; 2. Pregnant or breastfeeding patients; 3. Patients with active bleeding or postoperative status; 4. Patients receiving dialysis, extracorporeal circulation, or extracorporeal membrane oxygenation (ECMO); 5. Patients with a history of organ transplantation or receiving immunosuppressive therapy; 6. Patients using antiplatelet drugs; 7. Patients with non-sepsis-related thrombocytopenia, including: immune thrombocytopenia (patients who received platelet transfusion within 3 weeks before enrollment should be tested for platelet antibodies), hereditary thrombocytopenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, drug-related thrombocytopenia (such as ITP, HIT, PTP), and malignancy-related thrombocytopenia. Randomized controlled trials 1.Patients whose medical decisions are not suitable for participation in the study (patients with critical conditions, patients who died or were transferred out of the ICU within 48 hours, patients who had previously experienced serious adverse reactions to blood products, patients who had received organ transplants or were taking immunosuppressants, patients with immunodeficiency, etc.). 2.Pregnancy and lactation. 3.After differential diagnosis, other possible causes of thrombocytopenia cannot be ruled out except for thrombocytopenia caused by infection: active bleeding in the past 72 hours, surgery, extracorporeal circulation or ECMO use in the past ten days, immune thrombocytopenia (platelet antibody testing for patients who received platelet transfusions within 3 weeks before enrollment), hereditary thrombocytopenia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, drug-induced thrombocytopenia (ITP, HIT, PTP), and thrombocytopenia related to malignant tumors. 4.Special infections: severe fever with thrombocytopenia syndrome (SFTS) virus infection. 5.Long-term use of antiplatelet drugs before admission.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 28d all-cause mortality;90d all-cause mortality; | — |
Secondary
| Measure | Time frame |
|---|---|
| PIICS onset rate; | — |
Countries
China
Contacts
Public ContactYunhong Yu
The Third People's Hospital of Chengdu
Outcome results
None listed