Individual research recommendation details

Recommendation ID

NG24/4

Question

Fresh frozen plasma for patients with abnormal haemostasis who are having invasive procedures or surgery:- What dose of fresh frozen plasma is most clinically effective at preventing bleeding in patients with abnormal haemostasis who are having invasive procedures or surgery?

Any explanatory notes
(if applicable)

Why this is important:- Audits have shown that fresh frozen plasma is widely used for non-bleeding patients in the intensive care unit (ICU) and many other clinical settings. There is a large variation in dose and no real evidence base to guide practice. Fresh frozen plasma transfusions may cause adverse outcomes in people who are critically ill, including transfusion-related acute lung injury, transfusion-related circulatory overload, multi-organ failure and an increased risk of infections.
A multicentre study (2011) of ICUs in the UK showed that 12.7% of patients admitted to the ICU received fresh frozen plasma. The median dose was 10.8 ml/kg, but doses varied widely (range 2.4–41.1 ml/kg). This study showed that a high proportion of fresh frozen plasma transfusions had unproven clinical benefit.
Better evidence from clinical trials could significantly alter how fresh frozen plasma is used, and in particular ensure that clinically effective doses are given to patients.

Source guidance details

Comes from guidance

Blood transfusion

Number

NG24

Date issued

November 2015

Other details