Recombinant human thrombopoietin in critically ill patients with sepsis-associated thrombocytopenia: A clinical study

Abstract

Background: Sepsis causes varying degrees of thrombocytopenia that are closely related to the likelihood of patient mortality. This study analysed the effect of recombinant human thrombopoietin (rhTPO) on the platelet count in critically ill patients with sepsis-associated thrombocytopenia and provided a reference for its treatment. Material/methods: The study was a retrospective analysis of the clinical data of patients. Patients were divided into an rhTPO group and control group according to rhTPO use during treatment. Demographical and clinical data (age, sex, history of hypertension, diabetes, platelet counts, mortality rate, etc.) of the patients were collected and analysed using statistical software; p < 0.05 was considered statistically significant. Results: Of 213 patients, 84 constituted the rhTPO group and 129 constituted the control group. The increase in platelet counts was significantly higher in the rhTPO group than in the control group on the third day (43.01 AE 18.23 Â 10 9 /L vs. 36.31 AE 14.17 Â 10 9 /L, p = 0.003), fifth day (71.51 AE 39.59 Â 10 9 /L vs. 42.95 AE 20.48 Â 10 9 /L, p < 0.001) and seventh day (115.36 AE 69.41 Â 10 9 /L vs. 62.54 AE 42.70 Â 10 9 /L, p < 0.001). Further statistical analysis of the data of patients with platelet counts 30 Â 10 9 /L and >30 Â 10 9 /L and APACHE II scores >15 and 15 at the time of diagnosis showed that the increase in platelet counts in the rhTPO group was greater. There was no significant between-group difference in volume of platelet transfusions (rhTPO group 15.42 AE 17.20 vs. control group 10.93 AE 17.48, p = 0.068). The cost of ICU treatment in patients with rhTPO was higher (RMB 126,936.21 AE 86,548.27 vs. 101,685.28 AE 77,291.75, p = 0.027); however, the ICU stay time was shorter (9.20 AE 5.38 vs. 10.88 AE 6.82, p = 0.047). There was no significant difference in 28-day mortality (rhTPO group: 25.0% vs. control group: 34.1%, p = 0.158) between the two groups. Conclusion: For patients with severe thrombocytopenia or severe sepsis, rhTPO was efficacious in increasing their platelet counts, resulting in a shorter ICU stay time.

Platelet transfusion and mortality in patients with sepsis‐induced thrombocytopenia: A propensity score matching analysis

“…In recent years, several studies have suggested that rhTPO could rapidly lead to a recovery of the platelet count, increase the number of survival days and reduce the 28‐day mortality rate in sepsis patients with severe thrombocytopenia [10, 12]. Nevertheless, another study found that rhTPO was efficacious in increasing the patients' platelet counts, resulting in a shorter ICU stay (9.20 ± 5.38 vs. 10.88 ± 6.82 days, p = 0.047) for patients with severe thrombocytopenia and patients with severe sepsis, while there was no significant difference in 28‐day mortality (rhTPO group: 25.0% vs. control group: 34.1%, p = 0.158) [25]. Therefore, the question of whether patients with sepsis‐induced thrombocytopenia can benefit from rhTPO therapy still remains according to the controversial results.…”

Platelet Transfusion is Not Associated with the Better Outcomes of Patients with Sepsis-Induced Thrombocytopenia: A Propensity Score-Matching Analysis.

“…In another research, it suggested that rescue therapy with rhTPO could rapidly lead to a recovery of the platelet count, increase survival days and reduce the 28-day mortality in sepsis patients with severe thrombocytopenia (25). Nevertheless, Yu Liu et al found that rhTPO is e cacious in increasing the patients' platelet counts, resulting in a shorter ICU stay time (9.20 ± 5.38 vs 10.88 ± 6.82, p = 0.047) for patients with severe thrombocytopenia or patients with severe sepsis, while there was no signi cant difference in 28-days mortality ( rhTPO group: 25.0% vs. control group: 34.1%, p = 0.158) between the two groups (26). Therefore, whether patients with sepsis-induced thrombocytopenia can bene t from rhTPO therapy still remains a question according to the controversial results.…”

Atorvastatin improves bone marrow endothelial progenitor cell function from patients with immune-related hemocytopenia

“…TPO is a thrombopoietic growth factor produced by the liver that expressly regulates the release of platelets. Studies have found that recombinant human thrombopoietin (rhTPO) can reduce platelet and red blood cell transfusions in IRH patients (12,22).…”