Evaluation of Fresh Frozen Plasma Usage in Neonates

Area of Science:

• Neonatal Medicine
• Hematology
• Pediatric Critical Care

Background:

• Fresh frozen plasma (FFP) is a common transfusion product in neonatal intensive care units (NICUs).
• Established guidelines exist to limit FFP use, particularly in neonates.
• Variability in FFP transfusion practices is suspected but not well-characterized.

Purpose of the Study:

• To evaluate the utilization patterns of FFP in a neonatal intensive care unit.
• To assess adherence to national guidelines for FFP transfusions in neonates.
• To determine the association between FFP transfusion practices and clinical outcomes, including mortality and bleeding.

Main Methods:

• Retrospective analysis of neonates admitted to the NICU.
• Evaluation of demographic and clinical characteristics, transfusion data, and guideline adherence.
• Subgroup analyses based on gestational age (preterm/term), bleeding status, transfusion volume, and survival.

Main Results:

• Of 1538 neonates, 143 (9.3%) received 1279 units of FFP, with a mean of 8.9 units per patient.
• Only 20.3% of FFP transfusions met guideline criteria; 69.9% received multiple units.
• Multiple FFP transfusions correlated with higher mortality (P=0.017) and increased risk of multisite bleeding (OR=2.58).

Conclusions:

• FFP is frequently transfused in NICUs, often not aligning with current guidelines.
• Transfusion practices for FFP show significant variability.
• Non-adherence to guidelines and multiple transfusions are associated with adverse outcomes in neonates.