Acute cardiac care & resuscitationRandomised controlled trial
Cold and Room-Temperature Platelets in Cardiac Surgery
- Randomised controlled trial
- phase 3
- multicentre
- partially blinded
- adaptive
- non-inferiority
- storage duration-ranging
- 27 sites in the US and Australia
Authors' conclusion
For patients undergoing cardiac surgery, CSPs stored up to 21 days are noninferior to RTPs for the control of active surgical bleeding.
Study context
- Population
- Pediatric and adult patients undergoing cardiac surgery with planned cardiopulmonary bypass, actively bleeding989 in primary analysis
- Participants
- 1,000 participants
- Comparison
- Cold-stored platelets vs room-temperature platelets
- Cold-stored platelets (CSPs)n = 650
- Room-temperature platelets (RTPs)n = 339reference
- Primary endpoint
- Hemostatic efficacy score (1 to 5; higher = greater bleeding); non-inferiority margin 1 point
Primary result
Hemostatic efficacy score
Mean difference
0.09
95% CrI −0.06 to 0.23
CSPs vs RTPs
mean difference 0.09 (95% CrI −0.06 to 0.23)
Non-inferiority margin 1 as printed, not drawn
As reported in the abstract
- CSPs non-inferior to RTPs for all cold-storage durations; probability
- >99.9%
Secondary outcomes
Median, mL/kg
| Outcome | CSPs | RTPs | difference in medians (95% CI) | |
|---|---|---|---|---|
| Chest tube output · 24 hours · not statistically different | 8.9 (IQR 5.2–15.4) | 8.4 (IQR 5.5–15.9) | 0.4 (−1.0 to 1.5) | |
| −2−1012Difference (linear scale) |
Mean
| Outcome | CSPs | RTPs | Estimate |
|---|---|---|---|
| Hemostatic efficacy score, CSPs as single group (post hoc) · post hoc analysis | 3.08 (SD 1.15) | 2.99 (SD 1.10) |
Safety
Thrombotic events, transfusion-associated AEs, ARDS, kidney failure, septic shock, mortality, reexploration
- No differences in venous or arterial thrombotic events, transfusion-associated adverse events, ARDS, kidney failure, septic shock or mortality
- Increased reexploration rates with CSPs
Original publication
Cold and Room-Temperature Platelets in Cardiac Surgery. JAMA. Published 17 August 2026. doi:10.1001/jama.2026.13328
Summarised from the published abstract; every number is checked against it