Fresh frozen plasma transfusion in critically ill medical patients with coagulopathy*

Dara, Saqib I.; Rana, Rimki; Afessa, Bekele; Moore, S. Breanndan; Gajic, Ognjen

doi:10.1097/01.ccm.0000186745.53059.f0

Cited by 177 publications

(126 citation statements)

References 17 publications

Supporting

Mentioning

116

Contrasting

Unclassified

Order By: Relevance

“…9 Recent studies suggested that abnormal coagulation blood tests including an elevated international normalized ratio or activated partial thromboplastin time are common in the critically ill, 9,61,62 and administration of FFP is neither effective in correcting these abnormal coagulation results nor necessarily able to prevent clinical bleeding. 62,63 Whole blood VE-POC tests, including thromboelastography (Teg ® ; Haemonetics ® , Braintree, MA, USA) and rotational thromboelastometry (Rotem ® ; The Tem Group, Basel, Switzerland), are increasingly used to guide FFP (and other blood products) transfusion in the perioperative and critical care settings.…”

Section: Benefits and Risks Of Ffp Transfusions In The Critically Illmentioning

confidence: 99%

“…6,7 In the latest audit of our critically ill patients, up to 27% of the ICU patients still received allogeneic RBC transfusions, especially common in those with multiple organ failure, despite adopting a restricted transfusion protocol. 8 Similarly, FFP (30%) and platelet (23%) transfusions remain common in the critically ill. 9,10 The findings of these epidemiological studies are not entirely surprising, because for better or worse, the clinical intuition to correct severely deranged physiology, such as anemia, or coagulation parameters before invasive procedures for someone who is also unwell in many other ways, is compelling. [9][10][11] Numerous studies assessing the benefits and risks of RBC and blood product transfusions have been published in the past few decades, but which and when patients should receive allogeneic blood products remain contentious and uncertain.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Context-dependent risks and benefits of transfusion in the critically ill

Harahsheh¹,

Ho²

2017

IJCTM

View full text Add to dashboard Cite

Transfusion of red blood cells (RBCs) and other blood products to critically ill patients is common. Blood products are expensive, and not without risks. Recent evidence from high-quality multicenter randomized controlled trials confirmed the safety of allogeneic RBC transfusions, including the use of aged RBCs, and mild to moderate anemia for most stable and nonbleeding critically ill patients. Emerging evidence suggests that a liberal RBC transfusion target may have potential divergent effects on patient outcomes depending on their clinical context, with possible harms for patients with gastrointestinal bleeding due to portal hypertension and, conversely, benefits for patients with severe underlying cardiovascular diseases. Despite an apparent increased risk of bleeding in critically ill patients with deranged coagulation parameters and thrombocytopenia, recent studies suggested that fresh frozen plasma (FFP) and platelet transfusions may not be beneficial and, indeed, also not very effective in correcting these abnormalities. As for patients who have active severe critical bleeding, use of empirical 1:1:1 RBC: platelets: FFP transfusion appears justifiable in an attempt to reduce deaths as a result of exsanguination. In conjunction with platelet count and fibrinogen concentration, whole blood viscoelastic and platelet function tests are particularly useful to assist clinicians to rationalize FFP and platelet transfusions, when imminent death from exsanguination is not anticipated. Because the risks and benefits of blood product transfusion are heavily context-dependent, a thorough consideration of the characteristics and clinical status of the patients, in conjunction with viscoelastic and platelet function tests, is needed to rationalize the decision to transfuse (or withhold) blood products -very much in line with the move toward the practice of individualized or personalized medicine.

show abstract

Section: Benefits and Risks Of Ffp Transfusions In The Critically Illmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Context-dependent risks and benefits of transfusion in the critically ill

Harahsheh¹,

Ho²

2017

IJCTM

View full text Add to dashboard Cite

show abstract

“…In other words, massive transfusion based on a more physiologic regime resembling whole blood will improve survival. With reference to good results in several studies a new international consensus has been developed: A ratio of 1:1:1 in PRBC:FFP:PLT is advocated [9,[20][21][22]. This ratio results in decreased mortality, less blood products needed and decreased costs per patient.…”

Section: Massive Transfusion Of Blood Productsmentioning

confidence: 99%

Massive transfusion in multi-trauma patients

Wessem¹,

Twigt²,

Duis³

et al. 2014

IJCRI

View full text Add to dashboard Cite

“…Терапия концентратом АТ, хотя и связана с повы шенным риском геморрагических осложнений при сеп сисе [9], может снизить летальность при ДВС синдроме [10], в то время как введение СЗП сопровождается меньшим риском кровотечения, но может вызвать дру гие осложнения у пациентов, находящихся в критичес ком состоянии (ухудшение дыхательной функции у па циентов с сепсисом вследствие острого повреждения легких, риск анафилактических реакций, гемотрансфу зионных конфликтов, передачи инфекции) [11][12][13]. Планируя наше исследование, мы попытались ответить на вопрос о сравнительной эффективности СЗП и кон центрата АТ для коррекции дефицита АТ у пациентов с ДВС синдромом.…”

unclassified