The majority of patients in septic shock are transfused with fresh-frozen plasma

Fresh-frozen plasma (FFP) transfusion may be widely used in patients in septic shock, but the use is not well-described. Our aim was to describe the current use of FFP transfusion in medical patients with septic shock.

This was a prospective cohort study of medical patients with septic shock (n = 60) admitted to two general intensive care units (ICUs) during a three-month period. Patients were divided into two groups, one received FFP transfusion, the other did not. Baseline characteristics, transfusions and outcome were compared between the groups. Episodes of bleeding, procedures and coagulation parameters were compared between days with and without FFP transfusion.

57% of the patients received a median of six (interquartile range: 3-10) units of FFP during their ICU stay. The FFP-transfused patients had higher sequential organ failure assessment scores at admission (13 (9-15) versus 10 (7-11), p = 0.02) than the untransfused patients, but there were no differences in simplified acute physiology score II or mortality. On days of FFP transfusion, international normalized ratio levels (1.8 (1.4-2.3) versus 1.3 (1.2-1.6), p < 0.0001) were higher, and invasive procedures (p < 0.0001), episodes of bleeding (p < 0.0001), transfusion of red blood cells (p < 0.0001) and platelets (p < 0.0001) more frequent than on days without transfusion. Two thirds of FFP transfusions were given to patients with clinical evidence of bleeding and/or as prophylaxis before invasive procedures.

The majority of medical ICU patients with septic shock received FFP transfusion. One third of the FFPs were given unrelated to invasive procedures or bleeding.

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