FRESH FROZEN PLASMA

Abstract

Introduction: As the use of Fresh Frozen Plasma (FFP) is having establishedcomplications including Allergic reactions, infectious complications, hemolysis, fluid overload, transfusion related acute lung injury (TRALI) and immune suppression, therefore it mustbe used cautiously. Objectives: To evaluate the inappropriate use of FFPs, to carry out anaudit of appropriateness of FFP transfusion with reference to international guidelines and setfoundations for blood bank and transfusion protocols. Study Design: Cross sectional study.Setting: Khyber Teaching Hospital Peshawar. Period: 6 months, 1st January 2016 to 30th June2016. Methods: During which FFP transfusion requests made to the blood bank by various unitsof the hospital were studied including general surgery, surgical ICU, general medicine, medicalICU, gynecology and obstetrics. Seventy Six requests were received that were judged using6 variables: indication for FFP use, sampling errors, laboratory analysis errors, interpretationerrors, dosage of FFP (number of units being transfused) and timing of FFP transfusion. Scoreof “1” was given for each correct variable. After matching data to the international protocols, ascore of 4-5 was taken as appropriate and <3 was classified as inappropriate. Results: TwentySeven (35.5%) FFP transfusions were done with a score of 4-5 and were considered appropriatewhile 49(64.5%) FFP transfusions were given a score of 3 or less and were consideredinappropriate. Conclusions: Almost two third of FFP were used inappropriately in our hospital,the commonest indication being acute Disseminated Intravascular Coagulation (DIC) andmostly requested from surgical units. Maximum cases of inappropriate transfusions were dueto wrong sampling techniques and wrong dosage calculations. Most inappropriate transfusionswere done in MICU. It is recommended that annual clinical audit of all blood products usageshould be conducted. Local guidelines for physicians and training programs for nurses andparamedics regarding proper use of blood products should be established.