1- Interno Imunohemoterapia, Hospital C.Cabral. 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
- 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. For the most part, FFP is not indicated to correct coagulation anomalies in the absence of bleeding and has only a very limited place in prophylaxis prior to invasive procedures. Furthermore, its use in surgical or traumatic bleeding should be guided by coagulation studies.
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 June 30th 2014; Evaluation of available clinical history, laboratory data and further transfusion needs for each patient.
Resultados: During the first semester of 2014, we received 853 transfusion requests: 64.4% male patients and 35.6% female; median age 68 years (min. 18; max. 87). Most transfusions were requested for therapeutic purposes (80.1% vs. 19.9% requested for prophylactic reasons) and the majority of requests (64.4%) included complete clinical information. The most frequent motives for the transfusion request were acute hemorrhage (46.9%), therapeutic plasma exchange (22%) and preparation for surgery or invasive procedures (17.8%). The main diagnosis were Cardiovascular disease (26.2%), Hepatobiliary disease (21.1%) and Thrombotic Thrombocytopenic Purpura/Hemolytic-uremic syndrome (16%). The majority of transfusions were administered in Intensive Care Units (33.7%) and Operating Rooms (26.1%). Only 5.5% were administered in the Emergency Department. In most cases (70.4%), clinical or laboratory evaluation transfusion efficacy was recorded.
Conclusões: Our results show that, in our institution, most FFP transfusions are used for therapeutic purposes (80.1%), although there is still a significant rate of profilactic transfusions. Our transfusion request forms are generally well filled out, including complete clinical information in 64.4% of cases. In about 70%, there was record of a clinical or laboratory evaluation of transfusion efficacy in about 77% of cases, there was record of a clinical or laboratory evaluation of transfusion efficacy.