Thrombocytopenia is a common complication of acute burn injury. It results from dilutional and other multi-factorial processes. IL-11 stimulates mega-karyocytopoiesis. We hypothesized using IL-11 in burns would reverse thrombocytopenia and decrease blood products usage.
25 patients were randomized to receive placebo or 50mcg/kg SC IL-11 if the platelet count decreased by a predetermined schema. Baseline demographics, serial lab data, adverse events and transfusion requirements were analysed over 14 days.
Placebo (12), IL-11 (13) patients were statistically matched for age, gender, and TBSA (median 35% for both groups). Mean and median platelets versus time by treatment groups was not statistically different (0.756). A positive trend to reduction of platelet transfusions was shown by Wilcoxon and Bootstrap analysis (p-0.431). No differences were detected in RBC transfusions. Kaplan-Meier analysis on time to effect was also inconclusive. Adverse events were documented but no differences were detected between groups.CONCLUSIONS: IL-11 stimulates mega-keryocyte function and platelet restoration. However, when compared to placebo in acute burns the null hypothesis is not proven. A trend in platelet transfusion needs was noted in the IL-11 group. Our sample size may not have been powered to detect our clinical and scientific observations.
Neumega (IL-11) may still be an important adjunctive therapy in the critically ill. A large multicenter trial is warranted.
B. Friedman, Wyeth-Ayerst Pharmaceuticals, grant monies, discussion of product research or unlabeled uses of product.