Transfusion of Fresh Frozen Plasma in Critically Ill Surgical Patients Is Associated With an Increased Risk of Infection.

Point-of-Care Coagulation Management in Intensive Care Medicine

“…Th e level of fi brinogen typically falls below the lower reference range after 150 % blood volume loss, followed by a decrease in other coagulation factors to 25 % activity after 200 % blood loss [19]. FFP alone, if given in suffi cient quantity (> 15-20 ml/kg), will most likely correct fi brinogen and most coagulation factor defi ciencies, but large volumes may be required, which are further associated with infectious complica tions [20] and multiple organ failure [21] ; therefore goal-directed therap y with coagulation factor concentrates should be preferred [18] in patients outside the clinica l setting of 'massive transfusion' .…”

“…Although FFP transfusion is often a routine part of transfusion protocols, its effi cacy is uncertain. Most notably, FFP administration is also associated with acute lung injury (ALI), volume overload, and nosocomial infection [20,21]. Additionally, trauma-associated coagulopathy is the consequence of a low admission fi brinogen level, which is independently associated with injury severity score, shock, and mortality at 24 h and 28 days after trauma.…”

“…In the past, FFP (15-30 ml/kg) was used as a source of replacement fi brinogen. But again, the transfusion of FFP is, under certain condi tions, associated with volume overload, sepsis, multiple organ failure, and increased peri operative mortality [20,21]. An alternative source of fi brinogen is fi bri nogen co ncentrate, which should be used at a concentration of 25-50 mg/kg.…”

Impact of Implementation of Rotem on Allogenic Blood Transfusions in Trauma Patients Following ICU Admission before and after Study

“…However, due to its significant influence towards complications, e.g. transfusion related acute lung injury (TRALI), transfusion associated circulatory overload (TACO) [11][12][13], and increase of nosocomial infections [14,15] the administration of FFPs is still discussed controversially. In this context, a point-of-care diagnostic like viscoelastic analyses of clot formation might reduce the transfusion of allogeneic blood products and thus, may influence the clinical outcome considerably.…”

Frozen blood transfusion practices: time for change

“…Apart from problems with establishing efficacy, there is increasing evidence that the transfusion of labile blood products is an independent risk factor for poorer clinical outcomes. [1][2][3] Ironically, there is a greater evidence base in many settings for the risks of allogeneic transfusion than there is for benefits. In this issue of the Journal Moylan et al describe an audit of FFP use at the Royal Darwin Hospital.…”