engleski

Treatment of surgical patients with fresh frozen plasma

Treatment with fresh frozen plasma (FFP) is very often not indicated in spite of precisely defined guidelines. A two-year retrospective analysis of surgical patients treated with FFP was undertaken in our Institution, including those from wards, ORs and ICUs. During the studied period there were 172 treatment episodes in which 573 units were used (139, 249 ml), with an average of 3.5 units or 859 ml per episode. Indications for transfusion were: in 113 episodes (66%) pathologic values of hemostasis tests (APTT ratio> 1.5, PT<50%, fibrinogen <1g/l, or other coagulation deficits) ; in 34 episodes (20%) acute bleeding (>4units of red cell concentrates), without coagulation testing ; in 19 episode (11%) the indication was conversion of oral anticoagulation drugs ; in 6 episodes (3%) there no adequate indication for transfusion. Analyzing the group of patients in whom indications for FFP transfusion were pathologic values of coagulation parameters, we found the following: the most frequent pathologic finding was PT, APTT, low fibrinogen values, and other less frequent deficits. Pathologic results were single or in combination with two or more pathologic findings. In patients in whom the reason for treatment was oral anticoagulant therapy, INR values were from 1.96 to 8.2. In conclusion, we can affirm that the indications for the use of FFP transfusion and dosage in surgical patients in our Institution are appropriate. The number of non indicated transfusions was minimal as the result of good clinical transfusion practice, which includes good laboratory and clinical hemostaseology and education of all health personnel engaged in transfusion treatment.

fresh frozen plasma; treatment; surgical patients

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