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Despite widespread use in bleeding patients, evidence comparing plasma products to other hemostatic therapies is lacking. No randomized controlled trials were found, highlighting a critical gap in understanding plasma

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Area of Science:

  • Hematology
  • Transfusion Medicine
  • Critical Care Medicine

Background:

  • Plasma products, including fresh frozen plasma, are widely used in diverse clinical settings for hemostasis.
  • Current clinical practice relies heavily on plasma for bleeding management, from massive transfusions to reversing anticoagulation.
  • However, comparative data on its efficacy against alternative hemostatic treatments remain limited.

Purpose of the Study:

  • To systematically review randomized controlled trials (RCTs) evaluating the efficacy and safety of therapeutic plasma in bleeding patients.
  • To compare plasma's effectiveness against other hemostatic interventions or placebo.
  • To identify the existing evidence base for plasma as a hemostatic agent.

Main Methods:

  • Comprehensive literature search of CENTRAL, MEDLINE, PubMed Central, and ongoing trial registries.
  • Inclusion criteria focused on RCTs assessing therapeutic plasma for bleeding patients.
  • Systematic review methodology was employed to analyze retrieved studies.

Main Results:

  • The initial search yielded 1243 unique publications, but no RCTs met the inclusion criteria.
  • Four nonrandomized studies provided limited data on therapeutic plasma, insufficient for comparative analysis due to small sample sizes and varied comparators.
  • Two ongoing trials are investigating plasma's efficacy and safety, but results are not yet available.

Conclusions:

  • There is a significant lack of high-quality evidence from randomized controlled trials to support or refute the use of plasma products as a primary hemostatic agent.
  • Existing nonrandomized data are insufficient to compare plasma with other hemostatic therapies.
  • Further high-quality research, particularly RCTs, is needed to establish the comparative effectiveness and safety of therapeutic plasma.