Fresh frozen plasma transfusion in critically ill medical patients with coagulopathy.

摘要: Objective: Although restrictive red cell transfusion practice has become a standard of care in the critically ill, data on use fresh frozen plasma (FFP) are limited. We hypothesized that FFP medical intensive unit is variable and liberal may not be associated with improved outcome. Design: Retrospective cohort study. Setting: A 24-bed tertiary referral center. Patients: All patients admitted to duringa 5-month period who had abnormal coag ulation defined as international normalized ratio (INR) >1.5-times normal. Interventions: None. Measurements Main Results: collected demographics, severity illness measured by Acute Physiology Chronic Health Evaluation (APACHE) III scores, INR, bleedingepisodes, complications. identified 115 coagulopathy (INR >1.5) but without active bleeding. total 44 (38.3%) received transfusion. INR was corrected 16 (36%) Median dose 17 mL/kgin vs. 10 those did ( p .018). There no difference age, sex, APACHE liver disease, Coumadin treatment, or level between receive FFP. Invasive procedures (68.2% 40.8%, .004) history recent gastrointestinal bleeding (41% 7%, < .001) were more frequent group there new bleedingepisodes (6.8% transfused 2.8% nontransfused group, .369), onset acute lung injury (18% 4%, .021). Adjusted for illness, hospital mortality length stay among survivors different two groups. Conclusion: The risk– benefit ill favorable. Randomized controlled trials evaluatingrestrictive strategies warranted. (Crit Care Med 2005; 33:2667–2671)