open access

Vol 10, No 3 (2017)
Research paper
Published online: 2017-10-25
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Clinical Use of Fresh Frozen Plasma in a Tertiary Care Hospital from India

Manish Raturi, Shamee Shastry, Mohandoss Murugesan, Poornima B Baliga
Journal of Transfusion Medicine 2017;10(3):77-83.

open access

Vol 10, No 3 (2017)
ORIGINAL PAPERS
Published online: 2017-10-25

Abstract

Background. Increased utilization of fresh frozen plasma (FFP) over the last decade has
caused a rising trend in its unjustified usage exposing recipients to both infectious and non-
-infectious hazards. The aim of the study was to observe the pattern of clinical use of plasma
at a tertiary care hospital from India.
Material and methods. Prospective analysis of all the requests raised for plasma was carried
out. Indicators namely homogeneity of the requisition forms, patient demographics, indications
for transfusion, dosage, pre-transfusion coagulation parameters and adverse events were
noted. Appropriateness was defined based on compliance to both national and international
standards. Data was analyzed using SPSS version 20 (IBM, USA).
Results. Total nine hundred ninety eight patients (Males: 66%) received 4991 units of
plasma at an average of two episodes per patient. Majority were adults 83.6% (n = 835).
Primary users were internal medicine (32%) and plastic surgery (17%) respectively. Most
common indication was bleeding with coagulopathy seen in 41% (411/998) patients. Average
plasma volume administered was 456.2 ± 287.4 (17 to 2800) mL per episode. Pre-
-transfusions INR value was available in only 63.2% (n = 1317) episodes. Overall, 56% (n
= 1169) episodes were deemed appropriate. Total 0.28% plasma related adverse reactions
were seen and reported to the national hemovigilance database. Mortality in the study group
was 7.2%.
Conclusion. Existing transfusion practices for plasma use were moderately compliant with
the standards. Commonest indications for inappropriate FFP use were for low protein states
and prophylaxis without any evidence of bleeding.

Abstract

Background. Increased utilization of fresh frozen plasma (FFP) over the last decade has
caused a rising trend in its unjustified usage exposing recipients to both infectious and non-
-infectious hazards. The aim of the study was to observe the pattern of clinical use of plasma
at a tertiary care hospital from India.
Material and methods. Prospective analysis of all the requests raised for plasma was carried
out. Indicators namely homogeneity of the requisition forms, patient demographics, indications
for transfusion, dosage, pre-transfusion coagulation parameters and adverse events were
noted. Appropriateness was defined based on compliance to both national and international
standards. Data was analyzed using SPSS version 20 (IBM, USA).
Results. Total nine hundred ninety eight patients (Males: 66%) received 4991 units of
plasma at an average of two episodes per patient. Majority were adults 83.6% (n = 835).
Primary users were internal medicine (32%) and plastic surgery (17%) respectively. Most
common indication was bleeding with coagulopathy seen in 41% (411/998) patients. Average
plasma volume administered was 456.2 ± 287.4 (17 to 2800) mL per episode. Pre-
-transfusions INR value was available in only 63.2% (n = 1317) episodes. Overall, 56% (n
= 1169) episodes were deemed appropriate. Total 0.28% plasma related adverse reactions
were seen and reported to the national hemovigilance database. Mortality in the study group
was 7.2%.
Conclusion. Existing transfusion practices for plasma use were moderately compliant with
the standards. Commonest indications for inappropriate FFP use were for low protein states
and prophylaxis without any evidence of bleeding.

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Keywords

fresh frozen plasma; appropriateness; clinical usage; guidelines

Supp./Additional Files (4)
Table 1: Diagnosis-wise distribution of fresh frozen plasma usage in patients
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Table 2: Mean Change in INR per episode of plasma transfusion in the various indications
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Figure1: Degree of homogeneity of information on the blood requisition forms
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302KB
Figure 2: Dosage of Plasma administered to patients according to body weight
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235KB
About this article
Title

Clinical Use of Fresh Frozen Plasma in a Tertiary Care Hospital from India

Journal

Journal of Transfusion Medicine

Issue

Vol 10, No 3 (2017)

Article type

Research paper

Pages

77-83

Published online

2017-10-25

Bibliographic record

Journal of Transfusion Medicine 2017;10(3):77-83.

Keywords

fresh frozen plasma
appropriateness
clinical usage
guidelines

Authors

Manish Raturi
Shamee Shastry
Mohandoss Murugesan
Poornima B Baliga

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