ICU Clinicians' View on Platelet Transfusion Thresholds for a Future Trial—Protocol for an International Survey

Background: Thrombocytopenia is frequent in adult intensive care unit (ICU) patients and may contribute to adverse outcomes, including bleeding, morbidity and mortality. To reduce the risk of bleeding, platelet transfusions are commonly used, yet transfusion thresholds vary, and the evidence base is very limited. Randomised clinical trials investigating platelet transfusion strategies in ICU patients are therefore a high research priority. With this survey, we aim to assess ICU doctors' willingness to randomise adult ICU patients to restrictive versus liberal platelet transfusion thresholds across clinically relevant scenarios in a future randomised trial. Methods: We will conduct an international, web-based survey targeting ICU doctors within an established research network. The survey includes questions on respondent characteristics and willingness to enrol patients with an indication for platelet transfusion across a range of transfusion thresholds in different clinical scenarios, including non-bleeding patients, those undergoing invasive procedures, and those with bleeding. The survey has been pilot-tested and refined twice before distribution. We will summarise results using descriptive statistics and conduct stratified analyses by country and ICU type. Conclusions: This international survey will assess ICU doctors' willingness to randomise adult ICU patients to restrictive versus liberal platelet transfusion strategies across multiple clinical scenarios.