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Published on: February 24, 2021
[Reasons for fresh frozen plasma transfusion in a general hospital]
L Pita-Ramírez1, B E Cabrera Carbajal, C Ortega Zavala
1Servicio de Hematología, Hospital General Vasco de Quiroga (HG-VQ), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Morelia, Michoacán. pital@mail.giga.com
Objective:
To assess the fresh-frozen plasma (FFP) transfusion indications in a Mexican hospital.
Setting:
A general hospital for federal government employees located in the city of Morelia, State of Michoacan, Mexico.
Material And Methods:
We evaluated all FFP transfusions between February and August, 1998 classifying them as appropriate or inappropriate according to the recent FFP-transfusion guidelines: correction of known coagulation factor deficiencies with bleeding and correction of microvascular bleeding when prothrombin and activated partial thromboplastin time are > 1.6 times normal (coagulation index o CI), urgent reversal of warfarin therapy, antithrombin III deficiency, thrombotic thrombocytopenic purpura treatment, liver transplant and acute disseminated intravascular coagulation.
Results:
78 patients with 292 FFP units transfused were analyzed: in 20 patients the indication was clotting support, 16 with CI < 1.5 and four with CI > 1.6, one with blood loss and one with surgical procedure; hypoalbuminemia in 10; hypovolemia in eight; unidentified reason in 33 and others in seven patients. Eleven units (3.76%) were considered properly transfused whereas 281 (96.23%) were inadequately indicated.
Insights
Fresh-frozen plasma (FFP) transfusions in a Mexican hospital were rarely indicated appropriately. Over 96% of FFP units were transfused without meeting current transfusion guidelines, highlighting a significant need for improved clinical practice.
Area of Science:
- Transfusion Medicine
- Hematology
- Clinical Pathology
Background:
- Fresh-frozen plasma (FFP) is a blood product used to correct coagulation factor deficiencies.
- Appropriate transfusion guidelines exist to ensure effective and safe use of FFP.
- Assessing transfusion practices is crucial for optimizing patient care and resource allocation.
Purpose of the Study:
- To evaluate the indications for fresh-frozen plasma (FFP) transfusions in a Mexican hospital.
- To determine the adherence to established FFP transfusion guidelines.
Main Methods:
- A retrospective analysis of FFP transfusions was conducted.
- The study period was February to August 1998.
- Transfusions were classified as appropriate or inappropriate based on recent FFP transfusion guidelines.
Main Results:
- A total of 292 FFP units were transfused in 78 patients.
- Only 3.76% of FFP units (11 units) were transfused appropriately.
- A significant majority, 96.23% (281 units), were inadequately indicated, with many for unspecified reasons or suboptimal coagulation index values.
Conclusions:
- The study found a very low rate of appropriate fresh-frozen plasma (FFP) transfusions in the evaluated Mexican hospital.
- Current FFP transfusion practices deviate significantly from established guidelines.
- There is a critical need for education and implementation of evidence-based transfusion protocols to improve FFP utilization.
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