Randomized Clinical Trial of FFP Transfusion for Coagulopathic Critically Ill Patients

Transfusion guidelines recommend using fresh-frozen plasma (FFP) for patients with clotting factor deficiencies during major bleeding events. In addition, FFP is transfused as a prophylactic measure for non-bleeding patients with a clotting or bleeding disorder, especially before an invasive procedure.

However, FFP transfusions are associated with adverse events, such as acute lung injury. Researchers in the Netherlands performed a multicenter, randomized, open-label trial for critically ill patients scheduled for invasive procedures with international normalized ratios between 1.5 and 3.0. Although the target enrollment was not reached, 81 patients were randomly assigned—40 to receive FFP transfusions and 41 for no FFP transfusions. Researchers found no difference in bleeding or lung injury scores between the two groups; 8 minor bleeds in the FFP transfusion group and 1 major and 5 minor bleeds in the no FFP transfusion group were observed (p=0.77) . Data are consistent with pervious observations that prophylactic FFP transfusions may not affect bleeding outcomes of patients, but additional studies are required.

Reference

1. Muller MC, Arbous MS, Spoelstra-de Man AM, Vink R, Karakus A, Straat M, Binnekade JM, de Jonge E, Vroom MB, Juffermans NP. Transfusion of fresh-frozen plasma in critically ill patients with a coagulopathy before invasive procedures: a randomized clinical trial (CME). Transfusion 2015;55: 26-35.

Transfusion offers CME credit for this study! Log on at www.wileyhealthlearning.com/trf.