Platelet Concentrate Infusion Interval
Each unit of platelet concentrate should be infused over 30 minutes, with no mandatory waiting interval between consecutive units when multiple units are required. 1, 2
Standard Infusion Protocol
Infusion Rate for Single Units
- Each individual platelet concentrate unit is infused over 30 minutes through a standard blood administration set with a 170–200 μm filter 1
- When transfusing pooled platelet concentrates (4–6 units), the total transfusion time is 2–4 hours, with each unit taking 30–60 minutes 2
- A complete apheresis unit (250–350 mL) should be infused over 30–60 minutes 1, 2
Sequential Unit Administration
- There is no required waiting interval between consecutive platelet units—they may be administered back-to-back when rapid platelet replacement is needed 2
- In urgent bleeding scenarios, platelets should be transfused as rapidly as tolerated to achieve hemostatic targets quickly 2
- Transfusion should ideally commence within 30 minutes of removal from the platelet storage incubator at 22°C 1
Clinical Context Modifications
Prophylactic Transfusion (Non-Bleeding Patients)
- Standard 30-minute infusion per unit is appropriate 1
- For patients receiving prophylactic transfusions in hematology-oncology settings, the typical interval between repeat transfusions is every 2–4 days, based on platelet count monitoring rather than a fixed time schedule 2
Active Bleeding or Massive Transfusion
- Infuse as rapidly as the patient's cardiovascular status permits to achieve target platelet counts >50 × 10⁹/L (general bleeding) or >100 × 10⁹/L (severe hemorrhage, traumatic brain injury) 2, 3
- In massive transfusion protocols using 1:1:1 ratios, platelets should be included in the first transfusion pack without delay 2
Volume Considerations
- Each pooled platelet concentrate pack contains 250–350 mL 1
- Apheresis units contain 150–450 mL 2
- For patients at risk of volume overload, infusion speed may be slowed, but this is a clinical judgment based on cardiac status rather than a platelet-specific requirement 2
Post-Transfusion Monitoring
- Check platelet count 10–60 minutes after transfusion completion to verify adequate increment 4
- Expected increment: 5–10 × 10⁹/L per single whole-blood-derived unit or >30 × 10⁹/L per apheresis unit 2, 3
- If the post-transfusion count remains at or below the trigger level, administer additional units immediately without waiting 4
Critical Safety Points
- Never use a blood administration set that has already been used for red cells 1
- Do not add drugs directly to platelet units 1
- Never refrigerate platelets—they must remain at 22°C with constant gentle agitation until transfusion 1
- Platelets stored at 4°C have severely compromised viability and function 5