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Blood transfusion is a therapeutic measure to restore the blood volume after extensive blood loss due to an accident or a medical procedure. Blood transfusion involves drawing a certain amount of blood from a suitable donor and infusing it into the recipient.
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Related Experiment Video

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Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload
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Plasma transfusion in the intensive care unit.

Maite M T van Haeren1,2, Senta Jorinde Raasveld1,2, Sanne de Bruin1

  • 1Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, the Netherlands.

Transfusion
|December 19, 2024
PubMed
Summary

Plasma transfusions are common in ICUs, with over a third given unnecessarily for non-bleeding reasons. Improving adherence to guidelines for plasma use is crucial.

Keywords:
ICUcritically illintensive care unitplasmatransfusiontransfusion practices

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Area of Science:

  • Critical Care Medicine
  • Transfusion Medicine
  • Hematology

Background:

  • Current guidelines recommend against prophylactic plasma use in non-bleeding intensive care unit (ICU) patients.
  • This study evaluates global plasma transfusion practices in ICUs and their adherence to existing guidelines.

Purpose of the Study:

  • To assess the incidence and indications of plasma transfusions in ICU patients globally.
  • To determine the alignment of current plasma transfusion practices with established clinical guidelines.

Main Methods:

  • A sub-study of an international, prospective, observational cohort.
  • Primary outcomes included in-ICU plasma transfusion rates, proportion of plasma events among all blood product events, and units per event.
  • Secondary outcomes focused on transfusion indications, International Normalized Ratio/Prothrombin Time (INR/PT), and non-bleeding indications.

Main Results:

  • 10% of 3643 ICU patients received plasma transfusions (547 events, 18% of all transfusions).
  • 37% of transfusions were for non-bleeding indications, often with low pre-transfusion INR (<3.0 or <1.5).
  • Guidelines for INR/PT were not stated for over half of events, and pre-transfusion testing was missing in 27%.

Conclusions:

  • Plasma transfusions are frequently administered in ICUs, with a significant proportion for non-bleeding indications, suggesting potentialAvoidability.
  • Inconsistent adherence to guidelines regarding transfusion indications and pre-transfusion testing (INR/PT, VHA) was observed.
  • Further research and education are necessary to optimize plasma transfusion practices and guideline implementation in critical care settings.