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Early fresh frozen plasma prophylaxis of abnormal coagulation parameters in the severely head-injured patient is not
J P Winter1, D Plummer, A Bottini
1Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota 55415.
Serious head injury may be complicated by coagulation abnormalities. Fresh frozen plasma (FFP) has been advocated as resuscitation fluid, in patients with head injury, to prevent the development of abnormal coagulation. The efficacy of this practice has never been established. We retrospectively reviewed the records of 149 head-injured patients having a Glasgow Coma Scale of 9 or less. One hundred six received FFP and were without evidence of coagulopathies, while 42 received no FFP or had coagulopathies. Group 1 received FFP within a time from injury (T1) and group 2 received FFP after time (T2) or not at all. Groups were similar in demographics, injuries, presenting Glasgow Coma Scale, and presenting hematologic parameters in serial pretreatment or posttreatment hematologic parameters (P less than .05). There were no differences between patients receiving "early" FFP, as compared with those receiving FFP later or not at all. The time of FFP administration did not appear to be critical for effective prophylaxis against coagulopathy.
Serious head injury may be complicated by coagulation abnormalities. Fresh frozen plasma (FFP) has been advocated as resuscitation fluid, in patients with head injury, to prevent the development of abnormal coagulation. The efficacy of this practice has never been established. We retrospectively reviewed the records of 149 head-injured patients having a Glasgow Coma Scale of 9 or less. One hundred six received FFP and were without evidence of coagulopathies, while 42 received no FFP or had coagulopathies. Group 1 received FFP within a time from injury (T1) and group 2 received FFP after time (T2) or not at all. Groups were similar in demographics, injuries, presenting Glasgow Coma Scale, and presenting hematologic parameters in serial pretreatment or posttreatment hematologic parameters (P less than .05). There were no differences between patients receiving "early" FFP, as compared with those receiving FFP later or not at all. The time of FFP administration did not appear to be critical for effective prophylaxis against coagulopathy.