VPB0490 - Audit on the use of fresh frozen plasma in a Tertiary Care Hospital

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: Virtual

Presenting Author(s)

GE

Gabriela Simona Ene

Medical doctor
Banc de Sang i Teixits Hospital del Mar
Barcelona, Catalonia, Spain

Co-Author(s)

MR

Maria Carmen Raya Hinojosa

Lab technician
Hospital del Mar
Barcelona, Catalonia, Spain
LE

Lorena Edo Caballero

Lab technician
Hospital del Mar
Barcelona, Catalonia, Spain
AC

Ariana Carpi Medina

Lab technician
Hospital del Mar
Barcelona, Catalonia, Spain
AV

Albert Villaubi Serra

Lab technician
Hospital del Mar
Barcelona, Catalonia, Spain
NP

Natalia Palo Mauriz

Lab technician
Hospital del Mar
Barcelona, Catalonia, Spain
EM

Estela Membrilla Fernandez

Medical doctor Surgery Department
Hospital del Mar
Barcelona, Catalonia, Spain
JA

Juan Carlos Alvarez Garcia

Medical doctor Anesthesiology Department
Hospital del Mar
Barcelona, Catalonia, Spain

Background: The administration of fresh frozen plasma (FFP) has been proved to be inappropriate in many hospital settings although many guidelines recommend its use in specific situations.

Aims: To audit the usage FFP in our hospital and to establish the need for a different approach on the use of blood components in managing bleeding and acquired coagulopathies.

Methods: Medical records of patients who received FFP in our hospital during 2021 were retrospectively studied.The recommendations of the British Committee for Standards in Hematology were used to determine the correct use of plasma.

Results: A total of 291 units were issued in 100 cases (89 patients, 68 male, mean age 66 years, range 21-95 years).Bleeding related to surgery in the setting of altered coagulation, gastrointestinal bleeding and trauma represented the most common appropriate use of FFP.
Seven units of FFP were used to revert DOACs in 5 patients (3 on Apixaban, 1 on Edoxaban, 1 on Rivaroxaban) and 19 units were administered to 11 patients on VKA (5 patients with no bleeding and 6 with major bleeding that required urgent reversal). In 12 patients 34 units of FFP were used to correct the coagulation of patients on LMWH. After a thorough review only in 49 cases (197 units) the use of FFP was according to guidelines (average 4 units/patient). In 51 cases (94 units) the use was not based on guidelines recommendations (average 1.8 units/patient).

Conclusion(s): In our study we have observed that there is great variability in recommendations and amount of FFP administered. Its use requires a proper understanding of its indications since in some situations may even be deleterious, delaying the use of more effective products.
With an important decrease of blood donations, a critical eye should be placed on the use of FFP in managing bleeding as well as its use in non-bleeding patients.