Concurrent audit of fresh frozen plasma: experience of a tertiary care hospital

Fresh frozen plasma (FFP) transfusion is among the highest risk of all blood component transfusions and also the most inappropriately used blood component. All these factors have impact on safety, economy, and work burden.

To assess the utilization of FFP in a tertiary care hospital.

Concurrent audit was conducted manually over the period of 4 months from April 2010 to July 2010. Patient's age, sex, clinical diagnosis, indication for FFP transfusion, and coagulation profile were noted. Data were analysed and episodes of transfusion were divided into appropriate and inappropriate. Requests were further classified according to the requesting department, clinical diagnosis, and coagulation profile.

A total of 1763 units of FFP were transfused to 560 patients in 877 episodes of requisition. Out of 877 episodes, about 686 (78.2%) requests were found to be inappropriate. Highest number of FFP requisitions was received from department of paediatrics and paediatric surgery (580 episodes). Most inappropriate requests were received from the department of orthopaedics (88.9%) and paediatrics (80.17%). The most common indication for FFP transfusion was surgical/traumatic bleeding/massive transfusion (40.9%) in which 68.5% requests were inappropriate. Out of 686 inappropriate episodes, the most common cause was in setting of normal or mildly altered coagulation profile irrespective of bleeding status of patient.

Inadvertent use of FFP is a major problem and guidelines are not strictly adhered to. Concurrent audit of FFP use needs to be done to make appropriate interventions to prevent misuse of this valuable commodity.