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Open Access 01-12-2013 | Review

Plasma in the PICU: why and when should we transfuse?

Authors: Sonia Labarinas, Delphine Arni, Oliver Karam

Published in: Annals of Intensive Care | Issue 1/2013

Abstract

Whereas red blood cell transfusions have been used since the 19th century, plasma has only been available since 1941. It was originally mainly used as volume replacement, mostly during World War II and the Korean War. Over the years, its indication has shifted to correct coagulation factors deficiencies or to prevent bleeding. Currently, it remains a frequent treatment in the intensive care unit, both for critically ill adults and children. However, observational studies have shown that plasma transfusion fail to correct mildly abnormal coagulation tests. Furthermore, recent epidemiological studies have shown that plasma transfusions are associated with an increased morbidity and mortality in critically ill patients. Therefore, plasma, as any other treatment, has to be used when the benefits outweigh the risks. Based on observational data, most experts suggest limiting its use either to massively bleeding patients or bleeding patients who have documented abnormal coagulation tests, and refraining for transfusing plasma to nonbleeding patients whatever their coagulation tests. In this paper, we will review current evidence on plasma transfusions and discuss its indications.

O’Shaughnessy DF, Atterbury C, Bolton Maggs P, Murphy M, Thomas D, Yates S, Williamson LM: Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 2004, 126: 11–28.CrossRefPubMed

Schmidt PJ: The plasma wars: a history. Transfusion 2012,52(Suppl 1):2S-4S.CrossRefPubMed

Stanworth SJ, Hyde CJ, Murphy MF: Evidence for indications of fresh frozen plasma. Transfus Clin Biol 2007, 14: 551–556. 10.1016/j.tracli.2008.03.008CrossRefPubMed

Stanworth SJ: The evidence-based use of FFP and cryoprecipitate for abnormalities of coagulation tests and clinical coagulopathy. Hematology Am Soc Hematol Educ Program 2007(1):179–186.

Ewalenko P, Deloof T, Peeters J: Composition of fresh frozen plasma. Crit Care Med 1986, 14: 145–146. 10.1097/00003246-198602000-00015CrossRefPubMed

Alhumaidan H, Cheves T, Holme S, Sweeney J: Stability of coagulation factors in plasma prepared after a 24-hour room temperature hold. Transfusion 2010, 50: 1934–1942. 10.1111/j.1537-2995.2010.02648.xCrossRefPubMed

Cardigan R, van der Meer PF, Pergande C, Cookson P, Baumann-Baretti B, Cancelas JA, Devine D, Gulliksson H, Vassallo R, de Wildt-Eggen J: Coagulation factor content of plasma produced from whole blood stored for 24 hours at ambient temperature: results from an international multicenter BEST Collaborative study. Transfusion 2011, 51: 50S-57S.CrossRefPubMed

Hellstern P, Solheim BG: The use of Solvent/Detergent treatment in pathogen reduction of plasma. Transfus Med Hemother 2011, 38: 65–70. 10.1159/000323552PubMedCentralCrossRefPubMed

Benjamin RJ, McLaughlin LS: Plasma components: properties, differences, and uses. Transfusion 2012,52(Suppl 1):9S-19S.CrossRefPubMed

10.

Scott E, Puca K, Heraly J, Gottschall J, Friedman K: Evaluation and comparison of coagulation factor activity in fresh-frozen plasma and 24-hour plasma at thaw and after 120 hours of 1 to 6°C storage. Transfusion 2009, 49: 1584–1591. 10.1111/j.1537-2995.2009.02198.xCrossRefPubMed

11.

Borgman MA, Maegele M, Wade CE, Blackbourne LH, Spinella PC: Pediatric trauma BIG score: predicting mortality in children after military and civilian trauma. Pediatrics 2011, 127: e892-e897. 10.1542/peds.2010-2439CrossRefPubMed

12.

Zink K, Sambasivan C, Holcomb J, Chisholm G, Schreiber M: A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study. Am J Surg 2009, 197: 565–570. discussion 570 10.1016/j.amjsurg.2008.12.014CrossRefPubMed

13.

Holland LL, Brooks JP: Toward rational fresh frozen plasma transfusion: the effect of plasma transfusion on coagulation test results. Am J Clin Pathol 2006, 126: 133–139. 10.1309/NQXHUG7HND78LFFKCrossRefPubMed

14.

Abdel-Wahab OI, Healy B, Dzik WH: Effect of fresh-frozen plasma transfusion on prothrombin time and bleeding in patients with mild coagulation abnormalities. Transfusion 2006, 46: 1279–1285. 10.1111/j.1537-2995.2006.00891.xCrossRefPubMed

15.

Vamvakas EC, Blajchman MA: Transfusion-related immunomodulation (TRIM): an update. Blood Rev 2007, 21: 327–348. 10.1016/j.blre.2007.07.003CrossRefPubMed

16.

Dzik WH: Leukoreduction of blood components. Curr Opin Hematol 2002, 9: 521–526. 10.1097/00062752-200211000-00010CrossRefPubMed

17.

Schneider SO, Rensing H, Graber S, Kreuer S, Kleinschmidt S, Kreimeier S, Muller P, Mathes AM, Biedler AE: Impact of platelets and fresh frozen plasma in contrast to red cell concentrate on unstimulated and stimulated cytokine release in an in vitro model of transfusion. Scand J Immunol 2009, 70: 101–105. 10.1111/j.1365-3083.2009.02278.xCrossRefPubMed

18.

Heiden M, Seitz R: Quality of therapeutic plasma-requirements for marketing authorization. Thromb Res 2002,107(Suppl):S47-S51.CrossRefPubMed

19.

Weisbach V, Wanke C, Zingsem J, Zimmermann R, Eckstein R: Cytokine generation in whole blood, leukocyte-depleted and temporarily warmed red blood cell concentrates. Vox Sang 1999, 76: 100–106. 10.1046/j.1423-0410.1999.7620100.xCrossRefPubMed

20.

Rapport Annuel Hemovigilance 2010 Agence française de sécurité sanitaire des produits de santé 2011, 68.

21.

Stramer SL: Current risks of transfusion-transmitted agents: a review. Arch Pathol Lab Med 2007, 131: 702–707.PubMed

22.

Khan H, Belsher J, Yilmaz M, Afessa B, Winters JL, Moore SB, Hubmayr RD, Gajic O: Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest 2007, 131: 1308–1314. 10.1378/chest.06-3048CrossRefPubMed

23.

Holness L, Knippen MA, Simmons L, Lachenbruch PA: Fatalities caused by TRALI. Transfus Med Rev 2004, 18: 184–188. 10.1016/j.tmrv.2004.03.004CrossRefPubMed

24.

Sadis C, Dubois MJ, Mélot C, Lambermont M, Vincent JL: Are multiple blood transfusions really a cause of acute respiratory distress syndrome? Eur J Anaesthesiol 2007, 24: 355–361. 10.1017/S0265021506001608CrossRefPubMed

25.

Stainsby D, Jones H, Wells AW, Gibson B, Cohen H, on behalf of the SHOT Steering Group: Adverse outcomes of blood transfusion in children: analysis of UK reports to the serious hazards of transfusion scheme 1996–2005. Br J Haematol 2008, 141: 73–79. 10.1111/j.1365-2141.2008.07022.xCrossRefPubMed

26.

Sarani B, Dunkman WJ, Dean L, Sonnad S, Rohrbach JI, Gracias VH: Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection. Crit Care Med 2008, 36: 1114–1118. 10.1097/CCM.0b013e318168f89dCrossRefPubMed

27.

Church G, Matthay MA, Liu K, Milet M, Flori HR: Blood product transfusions and clinical outcomes in pediatric patients with acute lung injury. Pediatr Crit Care Med 2009, 10: 297–302. 10.1097/PCC.0b013e3181988952PubMedCentralCrossRefPubMed

28.

Karam O, Lacroix J, Robitaille N, Rimensberger PC, Tucci M: Association between plasma transfusions and clinical outcome in critically ill children: a prospective observational study. Vox Sang 2013, 104: 342–349. 10.1111/vox.12009CrossRefPubMed

29.

Narick C, Triulzi DJ, Yazer MH: Transfusion-associated circulatory overload after plasma transfusion. Transfusion 2012, 52: 160–165. 10.1111/j.1537-2995.2011.03247.xCrossRefPubMed

30.

Liumbruno G, Bennardello F, Lattanzio A, Piccoli P, Rossetti G, Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) Work Group: Recommendations for the transfusion of plasma and platelets. Blood Transfus 2009, 7: 132–150.PubMedCentralPubMed

31.

Report of the US Department of Health and Human Services: The 2009 National Blood Collection and Utilization Survey Report. Washington, DC; 2011.

32.

Puetz J, Witmer C, Huang Y-SV, Raffini L: Widespread use of fresh frozen plasma in US children’s hospitals despite limited evidence demonstrating a beneficial effect. J Pediatr 2012, 160: 210–215. 10.1016/j.jpeds.2011.08.013CrossRefPubMed

33.

Dzik W, Rao A: Why do physicians request fresh frozen plasma? Transfusion 2004, 44: 1393–1394. 10.1111/j.0041-1132.2004.00422.xCrossRefPubMed

34.

Lauzier F, Cook D, Griffith L, Upton J, Crowther M: Fresh frozen plasma transfusion in critically ill patients. Crit Care Med 2007, 35: 1655–1659. 10.1097/01.CCM.0000269370.59214.97CrossRefPubMed

35.

Arnold DM, Lauzier F, Whittingham H, Zhou Q, Crowther MA, McDonald E, Cook DJ: A multifaceted strategy to reduce inappropriate use of frozen plasma transfusions in the intensive care unit. J Crit Care 2011, 26: 636.e7–636.e13. 10.1016/j.jcrc.2011.02.005CrossRef

36.

Shariff M, Maqbool S, Butt TK, Iqbal S, Mumtaz A: Justifying the clinical use of fresh frozen plasma - an audit. J Coll Physicians Surg Pak 2007, 17: 207–210.PubMed

37.

Karam O, Tucci M, Lacroix J, Rimensberger P: Sondage international sur les seuils transfusionnels pour le plasma en réanimation pédiatriques. Reanimation 2013, 22: 26.

38.

Damiani G, Pinnarelli L, Sommella L, Farelli V, Mele L, Menichella G, Ricciardi W: Appropriateness of fresh-frozen plasma usage in hospital settings: a meta-analysis of the impact of organizational interventions. Transfusion 2010, 50: 139–144. 10.1111/j.1537-2995.2009.02371.xCrossRefPubMed

39.

Cooper ES, Bracey AW, Horvath AE, Shanberge JN, Simon TL, Yawn DH: Practice parameter for the use of fresh-frozen plasma, cryoprecipitate, and platelets. JAMA 1994, 271: 777–781. 10.1001/jama.1994.03510340067036CrossRef

40.

Expert Working Group: Guidelines for red blood cell and plasma transfusion for adults and children. CMAJ 1997, 156: S1-S24.PubMedCentral

41.

Bolliger D, Seeberger MD, Tanaka KA: Principles and practice of thromboelastography in clinical coagulation management and transfusion practice. Transfus Med Rev 2012, 26: 1–13. 10.1016/j.tmrv.2011.07.005CrossRefPubMed

42.

Afshari A, Wikkels o A, Brok J, Moller AM, Wetterslev J, Am MOL: Thrombelastography (TEG) or thromboelastometry (ROTEM) to monitor haemotherapy versus usual care in patients with massive transfusion. Cochrane Database Syst Rev 2011., 3: CD007871

43.

Stravitz RT, Lisman T, Luketic VA, Sterling RK, Puri P, Fuchs M, Ibrahim A, Lee WM, Sanyal AJ: Minimal effects of acute liver injury/acute liver failure on hemostasis as assessed by thromboelastography. J Hepatol 2012, 56: 129–136. 10.1016/j.jhep.2011.04.020CrossRefPubMed

44.

Agarwal B, Wright G, Gatt A, Riddell A, Vemala V, Mallett S, Chowdary P, Davenport A, Jalan R, Burroughs A: Evaluation of coagulation abnormalities in acute liver failure. J Hepatol 2012, 57: 780–786. 10.1016/j.jhep.2012.06.020CrossRefPubMed

45.

Segal JB, Dzik WH: Paucity of studies to support that abnormal coagulation test results predict bleeding in the setting of invasive procedures: an evidence-based review. Transfusion 2005, 45: 1413–1425. 10.1111/j.1537-2995.2005.00546.xCrossRefPubMed

46.

Dzik WH: Predicting hemorrhage using preoperative coagulation screening assays. Curr Hematol Rep 2004, 3: 324–330.PubMed

47.

Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R: A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 2004, 350: 2247–2256.CrossRefPubMed

48.

Yang L, Stanworth S, Hopewell S, Doree C, Murphy M: Is fresh-frozen plasma clinically effective? An update of a systematic review of randomized controlled trials (CME). Transfusion 2012, 52: 1673–1686. quiz 1673 10.1111/j.1537-2995.2011.03515.xCrossRefPubMed

49.

Cotton BA, Au BK, Nunez TC, Gunter OL, Robertson AM, Young PP: Predefined massive transfusion protocols are associated with a reduction in organ failure and postinjury complications. J Trauma 2009, 66: 41–48. discussion 48–9 10.1097/TA.0b013e31819313bbCrossRefPubMed

50.

Nacoti M, Cazzaniga S, Lorusso F, Naldi L, Brambillasca P, Benigni A, Corno V, Colledan M, Bonanomi E, Vedovati S, Buoro S, Falanga A, Lussana F, Barbui T, Sonzogni V: The impact of perioperative transfusion of blood products on survival after pediatric liver transplantation. Pediatr Transplant 2012, 16: 357–366. 10.1111/j.1399-3046.2012.01674.xCrossRefPubMed

Title: Plasma in the PICU: why and when should we transfuse?
Authors: Sonia Labarinas
Delphine Arni
Oliver Karam
Publication date: 01-12-2013
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2013
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/2110-5820-3-16

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Plasma in the PICU: why and when should we transfuse?

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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