A Narrative Review of the Use of Thrombopoietin and Thrombopoietin Analogues in Trauma and Critical Illness.

Introduction: Studies exploring the use of thrombopoietin (TPO) in trauma and hemorrhage-associated thrombocytopenia are limited. Transfusion of platelets, whether as part of whole blood or component therapy, is a cornerstone of survival in trauma patients. Adjuncts to transfusion may prove useful in the pre-hospital setting or in other settings where the logistics or risks of transfusion may not prove feasible. The purpose of this review is to evaluate the literature for the applications of TPO in critical illness and trauma. Methods: We conducted a review of relevant literature to provide a comprehensive summary of the use of TPO in critically ill patients with thrombocytopenia secondary to a variety of etiologies. We used PubMed and EBSCO Discovery Services to identify relevant literature. Results: The review identified eleven studies exploring the use of thrombopoietin in critically ill patients from 2014-2025. The most frequent studies cited were retrospective cohort studies (n=3) and prospective cohort studies (n=3), followed by case reports and case series (n=2), randomized controlled trials (RCT) (n=2), and a systematic review with meta-analysis (n=1). The papers came from journals and registries worldwide to provide an accurate representation of many settings. Conclusions: There are few studies on the use of TPO for critical care and trauma. However, the limited data suggests that TPO may confer benefit in critically ill patients with thrombocytopenia. Further studies are needed to determine how TPO could be used within these populations.