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2023

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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EVALUATION OF PEDIATRIC PLASMA TRANSFUSIONS

Natalia Demydenko1, Anabela Aires2, Sofia Gouveia3, João Carreira4, Deonilde Espirito Santo5

1- Interno Imunohemoterapia, Hospital São José. Centro Hospitalar Lisboa Central.
2- Interno Imunohemoterapia, Hospital São José. Centro Hospitalar Lisboa Central.
3- Interno Imunohemoterapia, Hospital C.Cabral. Centro Hospitalar Lisboa Central.
4- Interno Imunohemoterapia, Hospital São José. Centro Hospitalar Lisboa Central.
5- Assistente Graduado Sénior, Imunohemoterapia, Centro Hospitalar Lisboa Central.

Poster
- Nata, Network for the Advancement of Patient Blood Management, Haemostasis nd Thrombosis. 17th Annual Symposium, Dublin, Republic of Ireland, April 14-15, 2016

Introdução: The correct use of blood components and hemoderivatives is a major concern for Transfusion Medicine Specialists. Although current indications for transfusing fresh-frozen plasma (FFP) are very limited, they are not always respected in clinical practice. Pediatric patients represent a special challenge, as there is little evidence for the effectiveness of FFP transfusion in this age group, particularly regarding prophylactic use. Furthermore, coagulation times in the neonate are usually longer than those in the adult, and are not necessarily related to increased bleeding risk. Shortening of prolonged clotting times following FFP administration is unpredictable and requires laboratorial confirmation.
Objetivo: As part of our blood management strategy, we decided to evaluate how is FFP being transfused in our institution, in order to reduce its inadequate administration.
Métodos: Retrospective analysis of all plasma transfusion requests received in the Blood Bank, between January 1st and December 31st 2014; Evaluation of available clinical history, laboratory data and further transfusion needs for each patient
Resultados: During 2014, we received 163 transfusion requests, regarding 97 patients: 48 males and 49 female; median age 5 years + 2 months. The majority of requests (58.8%) included complete clinical information. The most frequent motive for the transfusion request was acute hemorrhage (70.1%), followed by coagulation anomalies, either congenital or acquired (17.2%). Most patients were diagnosed with congenital malformations (72.2%), including 53.8% with cardiac defects and only 0.6% had a diagnosed coagulopathy. The majority of transfusions were administered in Intensive Care Units (60.1%) and Operating Rooms (30.1%). In most cases (76.7%), clinical or laboratory evaluation transfusion efficacy was recorded.
Conclusões: In our hospital, most pediatric FFP transfusions are used for therapeutic purposes, in patients with acute hemorrhage (70.1%). In about 77% of cases, there was record of a clinical or laboratory evaluation of transfusion efficacy.

Palavras Chave: Patient Blood Management, Pediatric patients