Cold-Stored Platelets Safe for Cardiac Surgery Patients

Cold-stored platelets are safe and maintain their hemostatic function for patients undergoing complex cardiac surgery, according to the findings of the landmark CHIPS trial. This research investigated the efficacy of extending platelet storage at temperatures between 1°C and 6°C (33.8°F and 42.8°F), a departure from the standard room-temperature storage which limits their shelf life to five days. The trial aimed to determine if this refrigeration method would compromise the platelets' ability to stop bleeding, a critical factor in major surgical procedures.

The CHIPS (Cold-stored, High-quality, In-hospital, Platelet-rich plasma) trial enrolled 2,100 participants across 57 sites in the United States and Canada. The primary outcome measured was the proportion of patients experiencing a major bleeding event within 30 days of surgery. Secondary outcomes included the number of red blood cell units transfused, the duration of mechanical ventilation, the length of intensive care unit (ICU) stay, and the overall hospital stay. The study's design involved a comparison between two groups: one receiving platelets stored at room temperature and the other receiving cold-stored platelets.

Results indicated that the rate of major bleeding was similar between the two groups, with 11.1% of patients in the room-temperature group experiencing such events compared to 10.4% in the cold-storage group. This finding suggests that refrigeration does not impair the critical function of platelets in controlling surgical bleeding. Furthermore, the study found no significant differences in the number of red blood cell units transfused, mechanical ventilation duration, or ICU and hospital lengths of stay between the groups. These results provide robust evidence that cold storage is a viable option for platelet preservation.

This development holds significant implications for blood banks and hospitals, potentially alleviating shortages of platelets, which are often in high demand. Standard platelet storage at room temperature requires constant agitation and has a short shelf life, leading to considerable wastage. By enabling longer storage periods through refrigeration, blood banks could improve inventory management, reduce discard rates, and ensure a more consistent supply of this vital blood component. The CHIPS trial's findings are expected to influence transfusion guidelines and practices, paving the way for more efficient and effective platelet utilization in critical care settings, particularly in complex surgeries like cardiac procedures where blood loss can be substantial.