Document Type
Article
Department
Anaesthesiology (East Africa)
Abstract
Background: Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines.
Study Design and Methods: This was a sub-study of an international, prospective, observational cohort. Primary outcomes were in-ICU occurrence rate of plasma transfusion, proportion of plasma events of total blood products events, and number of plasma units per event. Secondary outcomes included transfusion indications, INR/PT, and proportion of events for non-bleeding indications.
Results: Of 3643 patients included, 356 patients (10%) experienced 547 plasma transfusion events, accounting for 18% of total transfusion events. A median of 2 (IQR 1, 2) units was given per event excluding massive transfusion protocol (MTP) and 3 (IQR 2, 6) when MTP was activated. MTP accounted for 39 (7%) of events. Indications of non-MTP events included active bleeding (54%), prophylactic (25%), and pre-procedure (12%). Target INR/PT was stated for 43% of transfusion events; pre-transfusion INR/PT or visco-elastic hemostatic assays (VHA) were reported for 73%. Thirty-seven percent of events were administered for non-bleeding indications, 54% with a pre-transfusion INR < 3.0 and 30% with an INR < 1.5.
Discussion: Plasma transfusions occurred in 10% of ICU patients. Over a third were given for non-bleeding indications and might have been avoidable. Target INR/PT was not stated in more than half of transfusions, and pre-transfusion INR/PT or VHA was not reported for 27%. Further research and education is needed to optimize guideline implementation and to identify appropriate indications for plasma transfusion.
Publication (Name of Journal)
Transfusion
DOI
https://doi.org/10.1111/trf.18071
Recommended Citation
Haeren, M. M.,
Raasveld, S. J.,
Bruin, S.,
Reuland, M. C.,
Oord, C.,
Schenk, J.,
Aubron, C.,
Bakker, J.,
Cecconi, M.,
Lance, M.
(2024). Plasma transfusion in the intensive care unit. Transfusion, 1-15.
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_anaesth/50
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
