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Plasma transfusions in neonatal intensive care units: a prospective observational study
Nina A M Houben1,2, Suzanne Fustolo-Gunnink1,2,3, Karin Fijnvandraat3,4
1Sanquin Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|January 20, 2025
Summary
European neonatal intensive care units (NICUs) show significant variation in fresh frozen plasma transfusion practices for very preterm infants. This highlights a need for evidence-based guidelines, especially for non-bleeding indications.
Area of Science:
- Neonatology
- Pediatric Hematology
- Clinical Pharmacy
Background:
- Prophylactic fresh frozen plasma (FFP) and Octaplas transfusions are used in very preterm infants despite limited evidence of efficacy.
- Practices for plasma transfusions in neonatal intensive care units (NICUs) vary internationally.
- Understanding these variations is crucial for developing standardized care protocols.
Purpose of the Study:
- To describe current plasma transfusion practices in European neonatal intensive care units (NICUs).
- To investigate the prevalence, indications, and protocols for plasma transfusions in very preterm infants across Europe.
Main Methods:
- A prospective observational study was conducted across 64 NICUs in 22 European countries.
- The study period was 6 weeks per center between September 2022 and August 2023.
- Data collected included plasma transfusion prevalence, cumulative incidence, indications, volumes, infusion rates, and adverse effects in preterm infants (<32 weeks gestational age).
Main Results:
- 8.0% of 1143 infants received plasma transfusions, totaling 177 transfusions.
- Plasma transfusion prevalence varied significantly across Europe (0.3 transfusions per 100 admission days).
- Indications included active bleeding (29.4%), abnormal coagulation (23.7%), and volume replacement (21.5%), with varied volumes and infusion rates.
Conclusions:
- Significant variation exists in European plasma transfusion practices for very preterm infants.
- There is a critical need for evidence to guide neonatologists and inform clinical practice guidelines.
- Particular attention is required for non-bleeding indications where evidence is lacking.
