The effect of plasma transfusion on morbidity and mortality: a systematic review and meta-analysis

摘要: BACKGROUND: Plasma transfusion is increasingly performed without clear consensus on indications. We systematically reviewed the literature to summarize available evidence regarding benefits and harms of plasma in common clinical settings. STUDY DESIGN AND METHODS: searched electronic databases from inception through August 2009. Eligible studies enrolled adult patients transfused with compared a control group. Paired reviewers independently assessed for eligibility extracted quality outcome data. RESULTS: Thirty-seven met criteria, most which were observational. In undergoing massive transfusion, infusion at high plasma : red blood cell ratios was associated significant reduction risk death (odds ratio [OR], 0.38; 95% confidence interval [CI], 0.24-0.60) multiorgan failure (OR, 0.40; CI, 0.26-0.60). However, this very low due unexplained heterogeneity several other biases. single retrospective study, reduced mortality anticoagulated intracranial hemorrhage 0.29; 0.09-0.98). surgery trend toward increased 1.22; 0.73-2.03). developing acute lung injury 2.92; 1.99-4.29). CONCLUSIONS: Very-low-quality suggests that setting trauma may be failure. A survival benefit not demonstrated populations.