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Prophylactic FFP for Procedures?
- FFP is commonly transfused to correct abnormal coagulation studies prior to performing procedures in nonbleeding critically ill patients.
- Despite common practice, there is little to no supportive evidence to demonstrate a clinical benefit to transfusing FFP in this patient population.
- Muller, et al recently evaluated the use of FFP before invasive procedures in critically ill patients. Brief highlights include:
- Prospective, randomized, open-label study at 4 sites in the Netherlands
- 76 adult ICU patients with INRs between 1.5 and 3.0
- Procedures: central line placement, thoracentesis, percutaneous tracheostomy
- Result: no difference in major bleeding events between those who received FFP and those randomized to no FFP
- Take Home Point: In the nonbleeding critically ill patient, routine transfusion of FFP to correct lab abnormalities prior to procedures is not indicated.
References
- Hunt B. Bleeding and coagulopathies in critical care. NEJM 2014; 370:847-59.
- Muller MC, et al. Transfusion of fresh-frozen plasma in critically ill patients with a coagulopathy before invasive procedures: a randomized clinical trial. Transfusion 2014; epub ahead of print.