Fresh frozen plasma use in the NICU: a prospective, observational, multicentred study

Abstract

FFP transfusion is a relatively frequent intervention in the NICU. In the present analysis, we found a remarkably high proportion of FFP transfusions given to non-bleeding neonates for indications not compliant with guideline recommendations. Platelet counts and coagulation studies were poor predictors of clinical bleeding.

Temporal changes in blood product usage in preterm neonates born at less than 30 weeks' gestation in Canada

“…Previous studies report that up to 8% to 12% of neonates are transfused with FFP when all birthweights and gestational ages are included. At 15%, the higher use observed in our study likely reflects the inclusion of neonates born at less than 30 weeks' gestation only.…”

Utilization of frozen plasma, cryoprecipitate, and recombinant factor VIIa for children with hemostatic impairments: An audit of transfusion appropriateness

“…They noted that 34% of the time, FP was administered prophylactically to correct an abnormal coagulation result for children who were not bleeding or due for an upcoming procedure . Prospective audits performed in the UK and Italy report that high proportions of FP transfusions are given for nonbleeding prophylactic indications. A systematic review assessing the role of plasma as a volume expander in the NICU found no evidence for its routine use in infants <32 weeks without cardiac compromise and insufficient evidence for preterm neonates with signs of cardiovascular compromise.…”

Guidelines on transfusion for fetuses, neonates and older children

“…There is considerable uncertainty about appropriate use of FFP in neonates, which reflects the lack of evidence in this area. National audits have shown high proportions of FFP transfusions are given for prophylaxis: 42% of infant FFP transfusions in a UK audit (Stanworth et al , ) and 63% in a similar Italian audit (Motta et al , ). Prophylactic use of FFP, including prior to surgery, is of unproven benefit and uncertainty is compounded by the difficulty in defining a significant coagulopathy in this age group.…”