An Audit of plasma usage in Tertiary care hospital

Abstract

Aims and Objectives : 1) To evaluate the usage of plasma in a tertiary care hospital. 2) To evaluate reasons for inappropriate transfusion of plasma. Introduction: FFP contains plasma proteins and all the coagulation factors, including the labile factors V and VIII. There exist only a few firm indications for fresh frozen plasma transfusions and there is a growing consensus that most of the time this blood product is used inappropriately and without any scientific rationale.FFP transfusion is always associated with risks like TRALI,HLA alloimmunisation, Allergic reaction, anaphylactic shock, TTI etc, so FFP should only be transfused when indicated and in adequate volume to achieve haemostasis so that its benefits of transfusion overweighs the hazards of transfusion. Materials and Method : The present study was a prospective study done between Jan 2014 to July 2014 in patients having requested for Fresh Frozen Plasma with or without other components in terms of appropriateness and inappropriateness. The guidelines for plasma transfusion were benchmarked on the basis of American Association of Blood Bank in terms of indication and adequate volumes for transfusion. Result: In this study 1594 units of FFP were used during study in 420 patients in 478 episodes in which in 185 episodes transfusion was appropriate and in 293 episodes transfusion was inappropriate. So appropriate requests were 38% while inappropriate requests were 62%, department of general Surgery and obstetricand gynaecology were the departments with maximum number of inappropriate requests. Conclusion: A continual system of staff education and administrative intervention by conducting regular departmental CMEs will be helpful to reduce inappropriate use in future by making other departments aware of appropriate usage of plasma so that unnecessary transfusions and hazards of plasma transfusions could be minimised and plasma usage would really benefit the patient.