TY - JOUR
T1 - Plasma transfusion in the intensive care unit
AU - van Haeren, Maite M.T.
AU - Raasveld, Senta Jorinde
AU - the InPUT Study Group
AU - de Bruin, Sanne
AU - Reuland, Merijn C.
AU - van den Oord, Claudia
AU - Schenk, Jimmy
AU - Aubron, Cécile
AU - Bakker, Jan
AU - Cecconi, Maurizio
AU - Feldheiser, Aarne
AU - de Grooth, Harm Jan
AU - Meier, Jens
AU - Scheeren, Thomas W.L.
AU - McQuilten, Zoe
AU - Flint, Andrew
AU - Hamid, Tarikul
AU - Piagnerelli, Michaël
AU - Mahečić, Tina Tomić
AU - Benes, Jan
AU - Russell, Lene
AU - Aguirre-Bermeo, Hernan
AU - Triantafyllopoulou, Konstantina
AU - Chantziara, Vasiliki
AU - Gurjar, Mohan
AU - Myatra, Sheila Nainan
AU - Pota, Vincenzo
AU - Elhadi, Muhammed
AU - Gawda, Ryszard
AU - Mourisco, Mafalda
AU - Lance, Marcus
AU - Neskovic, Vojislava
AU - Podbregar, Matej
AU - Llau, Juan V.
AU - Quintana-Diaz, Manual
AU - Cronhjort, Maria
AU - Pfortmueller, Carmen A.
AU - Yapici, Nihan
AU - Nielsen, Nathan D.
AU - Shah, Akshay
AU - Vlaar, Alexander P.J.
AU - Müller, Marcella C.A.
AU - van Haeren, Maite M.T.
AU - Raasveld, Senta Jorinde
AU - de Bruin, Sanne
AU - Reuland, Merijn C.
AU - van den Oord, Claudia
AU - Schenk, Jimmy
AU - Aubron, Cécile
AU - Bakker, Jan
AU - Cecconi, Maurizio
N1 - Publisher Copyright:
© 2024 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB.
PY - 2025/1
Y1 - 2025/1
N2 - Background: Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines. Study Design and Methods: This was a sub-study of an international, prospective, observational cohort. Primary outcomes were in-ICU occurrence rate of plasma transfusion, proportion of plasma events of total blood products events, and number of plasma units per event. Secondary outcomes included transfusion indications, INR/PT, and proportion of events for non-bleeding indications. Results: Of 3643 patients included, 356 patients (10%) experienced 547 plasma transfusion events, accounting for 18% of total transfusion events. A median of 2 (IQR 1, 2) units was given per event excluding massive transfusion protocol (MTP) and 3 (IQR 2, 6) when MTP was activated. MTP accounted for 39 (7%) of events. Indications of non-MTP events included active bleeding (54%), prophylactic (25%), and pre-procedure (12%). Target INR/PT was stated for 43% of transfusion events; pre-transfusion INR/PT or visco-elastic hemostatic assays (VHA) were reported for 73%. Thirty-seven percent of events were administered for non-bleeding indications, 54% with a pre-transfusion INR < 3.0 and 30% with an INR < 1.5. Discussion: Plasma transfusions occurred in 10% of ICU patients. Over a third were given for non-bleeding indications and might have been avoidable. Target INR/PT was not stated in more than half of transfusions, and pre-transfusion INR/PT or VHA was not reported for 27%. Further research and education is needed to optimize guideline implementation and to identify appropriate indications for plasma transfusion.
AB - Background: Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines. Study Design and Methods: This was a sub-study of an international, prospective, observational cohort. Primary outcomes were in-ICU occurrence rate of plasma transfusion, proportion of plasma events of total blood products events, and number of plasma units per event. Secondary outcomes included transfusion indications, INR/PT, and proportion of events for non-bleeding indications. Results: Of 3643 patients included, 356 patients (10%) experienced 547 plasma transfusion events, accounting for 18% of total transfusion events. A median of 2 (IQR 1, 2) units was given per event excluding massive transfusion protocol (MTP) and 3 (IQR 2, 6) when MTP was activated. MTP accounted for 39 (7%) of events. Indications of non-MTP events included active bleeding (54%), prophylactic (25%), and pre-procedure (12%). Target INR/PT was stated for 43% of transfusion events; pre-transfusion INR/PT or visco-elastic hemostatic assays (VHA) were reported for 73%. Thirty-seven percent of events were administered for non-bleeding indications, 54% with a pre-transfusion INR < 3.0 and 30% with an INR < 1.5. Discussion: Plasma transfusions occurred in 10% of ICU patients. Over a third were given for non-bleeding indications and might have been avoidable. Target INR/PT was not stated in more than half of transfusions, and pre-transfusion INR/PT or VHA was not reported for 27%. Further research and education is needed to optimize guideline implementation and to identify appropriate indications for plasma transfusion.
UR - https://www.scopus.com/pages/publications/85212693976
U2 - 10.1111/trf.18071
DO - 10.1111/trf.18071
M3 - Article
C2 - 39696779
AN - SCOPUS:85212693976
SN - 0041-1132
VL - 65
SP - 73
EP - 87
JO - Transfusion
JF - Transfusion
IS - 1
ER -