Fresh frozen plasma and platelet transfusion for nonbleeding patients in the intensive care unit: Benefit or harm?

Ognjen Gajic, Walter H. Dzik, Pearl Toy

Research output: Contribution to journalArticle

105 Scopus citations

Abstract

Objective: Whereas restrictive red cell transfusion has become a standard of care for the critically ill, evidenced-based indications for use of other blood components such as fresh frozen plasma (FFP) and platelet transfusions are limited. We searched the National Library of Medicine PubMed database as well as references of retrieved articles and summarized the current evidence for the use of FFP and platelet transfusions in critically ill patients. Results: Routine coagulation tests are poor determinants of bleeding risk in critically ill patients with coagulopathy. FFP transfusion has limited efficacy and is associated with significant morbidity in critically ill patients, in particular, pulmonary edema and acute lung injury. Routine minimally invasive critical care procedures can be safely performed by experienced clinicians in the setting of mildly abnormal coagulation test results, and there is no evidence that FFP transfusion alters the risk of bleeding. For platelet transfusion, the American Society of Clinical Oncology has developed practice guidelines designed for oncology patients. However, because the pathophysiology of thrombocytopenia in critically ill patients often differs from that of thrombocytopenia in oncology patients, published guidelines for oncology patients may not be applicable. Conclusion: Because the risk-benefit ratio of a liberal FFP or platelet transfusion strategy for critically ill patients may not be favorable, randomized controlled trials are warranted for evaluating a restrictive vs. liberal FFP or platelet transfusion strategy for nonbleeding patients in the intensive care unit.

Original languageEnglish (US)
Pages (from-to)S170-S173
JournalCritical care medicine
Volume34
Issue number5 SUPPL.
DOIs
StatePublished - May 2006

Keywords

  • Clinical use
  • Fresh-frozen plasma
  • Outcome study
  • Platelet
  • Pulmonary edema
  • Transfusion

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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