A prospective audit of transfusion requests in a tertiary care hospital for the use of fresh frozen plasma

AIMS AND BACKGROUND: Like any other drug, therapeutic use of fresh frozen plasma (FFP) has its own side effects, adverse reactions and risks involved. Overall use of FFP has been on the increase in most tertiary care hospitals. Since the guidelines for FFP use in a clinical setting are not well defined, the present study aims at defining the appropriateness of use of FFP in the light of its risks and benefits as a drug. MATERIALS AND METHODS: We carried out a prospective survey of 821 transfusion orders for 2,915 units of fresh frozen plasma components in our hospital over a 4-month period and recorded indication for transfusion and the number of components requested. RESULTS: Five hundred seventy-three (69.8%) of transfusion requests affecting 2,202 (75.54%) units of FFP were appropriately indicated, while 248 (30.2%) of FFP requests were inappropriately indicated. The majority of fresh frozen plasma requests used were for surgical bleeding (22.77%) because of the deranged coagulation profile before surgery in most of the patients. It was followed by liver disease and transplantation (12.54%). Out of 821 patients, 586 were male and 235 were female. CONCLUSION: Inappropriate requests accounted for 30.2% of the total FFP requests in patients who had normal coagulation parameters. Regular audits, appropriate training of medical staff, conducting regular CMEs are the measures being incorporated in our hospital to rationalize the use of blood components.