Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients. Methods We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses. Results We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4–46.1) had thrombocytopenia; 23.4% (20–26) had thrombocytopenia at ICU admission, and 19.8% (17.6–22.2) developed thrombocytopenia during their ICU stay. Non-AIDS-, non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19–2.42). Conclusion Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.publishedVersio

Choix et gestion de couverts herbacés dans les jachères et les tournières faunistiques

Actes du XXIIIè Congrès de l'Union Internationale des Biologistes du Gibier (U.I.B.G.)Gibier Faune Sauvag

Feeding selection at grazing of the American bison (Bison bison)

p. 669-67

L’effet du style d’apprentissage sur la mémoire transactive d’équipes collaboratives en formation à distance

L’objectif de cette contribution est d’étudier l’effet du style d’apprentissage sur le système de mémoire transactive d’équipes collaboratives. Pour ce faire, trois modalités de constitution d’équipes ont été expérimentées auprès de 126 apprenants impliqués dans deux activités collectives. L’analyse du système de mémoire transactive révèle une influence positive de la modalité de constitution d’équipes. Le fait de constituer des équipes équilibrées en tenant compte du style d’apprentissage participatif favorise chez l’apprenant une meilleure perception de la spécialisation et de la crédibilité de ses coéquipiers.The aim of this research is to study the learning style on the transactive memory system. For this, three options of team constitution were analysed with 126 students involved in two consecutive small group activities. The analysis of the transactive memory system reveals a positive influence of the heterogeneity of learning profiles within the same team. Heterogeneity promotes a better understanding of the specialization and the credibility of the team members