Design: Phase 3, randomised, partially blinded, adaptive non-inferiority trial
Population: 989 children and adults bleeding during cardiac surgery on bypass
Primary outcome: Haemostatic efficacy score (1–5)
Effect: Mean difference 0.09 (95% credible interval −0.06 to 0.23); non-inferior at all durations

The CHIPS trial in JAMA (13 October) randomised 1,000 children and adults bleeding during cardiac surgery on bypass, 2:1, to platelets stored cold for up to 21 days or at room temperature for up to 7 days, at 27 sites in the US and Australia.

Cold-stored platelets were non-inferior for a five-point bleeding score at every storage duration tested; the pooled difference was 0.09 points. Chest-tube output at 24 hours was similar. Thrombosis, kidney failure and death did not differ, but re-exploration was more frequent with cold-stored platelets.

Room-temperature platelets expire within a week, which drives wastage and shortages. Cold storage could keep platelets on the shelf for smaller cardiac centres. The re-exploration signal needs following up before wide adoption.

Cold-stored platelets up to 21 days controlled bleeding about as well as standard platelets
Re-exploration was more frequent in the cold-stored group — ask your blood bank how it is tracked
The benefit is supply: longer shelf life, less wastage
Adoption depends on blood-bank licensing, not on the surgical team

Why it matters

Platelet shortages, not efficacy, often limit bleeding control in smaller cardiac units.

The statistics, in plain English

Non-inferiority means cold platelets were not worse by more than the pre-set margin of 1 point; the observed difference, 0.09 (credible interval −0.06 to 0.23), sits well inside it. This is a Bayesian trial, so it reports probabilities and credible intervals rather than P values.