scholarly journals Early Fresh Frozen Plasma Transfusion: Is It Associated With Improved Outcomes of Patients With Sepsis?

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyi Qin ◽  
Wei Zhang ◽  
Xiaodan Zhu ◽  
Xiang Hu ◽  
Wei Zhou
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
External Validation ◽  
Fresh Frozen Plasma ◽  
Plasma Transfusion ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Subset Analysis ◽  
Fresh Frozen ◽  
Frozen Plasma

Background: So far, no study has investigated the effects of plasma transfusion in the patients with sepsis, especially in the terms of prognosis. Therefore, we aimed to explore the association of early fresh frozen plasma (FFP) transfusion with the outcomes of patients with sepsis.Methods: We performed a cohort study using data extracted from the Medical Information Mart for Intensive Care III database (v1.4). External validation was obtained from the First Affiliated Hospital of Wenzhou Medical University, China. We adopted the Sepsis-3 criteria to extract the patients with sepsis and septic shock. The occurrence of transfusion during the first 3-days of intensive care unit (ICU) stay was regarded as early FFP transfusion. The primary outcome was 28-day mortality. We assessed the association of early FFP transfusion with the patient outcomes using a Cox regression analysis. Furthermore, we performed the sensitivity analysis, subset analysis, and external validation to verify the true strength of the results.Results: After adjusting for the covariates in the three models, respectively, the significantly higher risk of death in the FFP transfusion group at 28-days [e.g., Model 2: hazard ratio (HR) = 1.361, P = 0.018, 95% CI = 1.054–1.756] and 90-days (e.g., Model 2: HR = 1.368, P = 0.005, 95% CI = 1.099–1.704) remained distinct. Contrarily, the mortality increased significantly with the increase of FFP transfusion volume. The outcomes of the patients with sepsis with hypocoagulable state after early FFP transfusion were not significantly improved. Similar results can also be found in the subset analysis of the septic shock cohort. The results of external validation exhibited good consistency.Conclusions: Our study provides a new understanding of the rationale and effectiveness of FFP transfusion for the patients with sepsis. After recognizing the evidence of risk-benefit and cost-benefit, it is important to reduce the inappropriate use of FFP and avoid unnecessary adverse transfusion reactions.

scholarly journals Early Fresh Frozen Plasma Transfusion: Can It Improve the Outcomes of Patients With Sepsis?

2021 ◽  
Author(s):  
Xiaoyi Qin ◽  
Wei Zhang ◽  
Xiaodan Zhu ◽  
Xiang Hu ◽  
Wei Zhou
Keyword(s):  
Septic Shock ◽  
Intensive Care ◽  
External Validation ◽  
Fresh Frozen Plasma ◽  
Plasma Transfusion ◽  
Cox Regression Analysis ◽  
Risk Of Death ◽  
Subset Analysis ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Background: So far, no study has investigated the effects of plasma transfusion in septic patients, especially in terms of prognosis. Therefore, our purpose is to explore the association of early fresh frozen plasma (FFP) transfusion with the outcomes of septic patients.Methods: We performed a cohort study using data extracted from the Medical Information Mart for Intensive Care Ⅲ database (v1.4). External validation was obtained from the First Affiliated Hospital of Wenzhou Medical University, China. We adopted the Sepsis-3 criteria to extract patients with sepsis and septic shock. The occurrence of infusion during the first 3 days of intensive care unit stay was regarded as early FFP transfusion. The primary outcome was 28-day mortality. We assessed the association of early FFP transfusion with patient outcomes using cox regression analysis. Furthermore, we performed sensitivity analysis, subset analysis and external validation to verify the true strength of the results.Results: After adjusting for the covariates in 3 models respectively, the significantly higher risk of death in the FFP transfusion group at 28 days (e.g. Model 2: HR = 1.361, P = 0.018, 95% CI = 1.054–1.756) and 90 days (e.g. Model 2: HR = 1.368, P = 0.005, 95% CI = 1.099–1.704) remained distinctly. Contrarily, the mortality increased significantly with the increase of FFP transfusion volume. The outcomes of septic patients with low coagulation after early FFP transfusion were not significantly improved. Similar results can also be found in subset analysis of septic shock cohort. The results of external validation exhibited good consistency.Conclusions: Our study provides new understanding of the rationale and effectiveness of FFP transfusion for septic patients. After recognizing the evidences of risk-benefit and cost-benefit, it is important to reduce the inappropriate use of FFP and avoid unnecessary adverse transfusion reactions.

Fresh frozen plasma transfusion in critically ill patients*

2007 ◽  
Vol 35 (7) ◽  
pp. 1655-1659 ◽  
Author(s):  
François Lauzier ◽  
Deborah Cook ◽  
Lauren Griffith ◽  
Julia Upton ◽  
Mark Crowther
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Fresh Frozen Plasma ◽  
Plasma Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

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

2005 ◽  
Vol 33 (11) ◽  
pp. 2667-2671 ◽  
Author(s):  
Saqib I. Dara ◽  
Rimki Rana ◽  
Bekele Afessa ◽  
S Breanndan Moore ◽  
Ognjen Gajic
Keyword(s):  
Critically Ill ◽  
Fresh Frozen Plasma ◽  
Medical Patients ◽  
Plasma Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

Fresh frozen plasma transfusion fails to influence the hemostatic balance in critically ill patients with a coagulopathy

2015 ◽  
Vol 13 (6) ◽  
pp. 989-997 ◽  
Author(s):  
M. C. A. Müller ◽  
M. Straat ◽  
J. C. M. Meijers ◽  
J. H. Klinkspoor ◽  
E. de Jonge ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Fresh Frozen Plasma ◽  
Plasma Transfusion ◽  
Fresh Frozen ◽  
Frozen Plasma

Utility of Whole Blood Hemostatometry Using the Clot Signature Analyzer®for Assessment of Hemostasis in Cardiac Surgery

2002 ◽  
Vol 96 (5) ◽  
pp. 1115-1122 ◽  
Author(s):  
Nauder Faraday ◽  
Eliseo Guallar ◽  
Valerie A. Sera ◽  
Everlie D. Bolton ◽  
Robert B. Scharpf ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Whole Blood ◽  
Thrombus Formation ◽  
Fresh Frozen Plasma ◽  
Fibrinogen Concentration ◽  
Plasma Transfusion ◽  
Predictive Values ◽  
Signature Analyzer ◽  
Fresh Frozen ◽  
Frozen Plasma

Background A hemostatic monitor capable of rapid, accurate detection of clinical coagulopathy within the operating room could improve management of bleeding after cardiopulmonary bypass (CPB). The Clot Signature Analyzer is a hemostatometer that measures global hemostasis in whole blood. The authors hypothesized that point-of-care hemostatometry could detect a clinical coagulopathic state in cardiac surgical patients. Methods Fifty-seven adult patients scheduled for a variety of elective cardiac surgical procedures were studied. Anesthesia, CPB, heparin anticoagulation, protamine reversal, and transfusion for post-CPB bleeding were all managed by standardized protocol. Clinical coagulopathy was defined by the need for platelet or fresh frozen plasma transfusion. The Clot Signature Analyzer collagen-induced thrombus formation (CITF) assay measured platelet-mediated hemostasis in vitro. The activated clotting time, platelet count, prothrombin time, activated partial thromboplastin time, and fibrinogen concentration were also measured. Results The postprotamine CITF was greater in patients who required hemostatic transfusion than in those who did not (17.6 +/- 8.0 min vs. 10.5 +/- 5.7 min, respectively; P < 0.01). Postprotamine CITF values were highly correlated with platelet and fresh frozen plasma transfusion (Spearman r = 0.50, P < 0.001 and r = 0.40, P < 0.005, respectively). Receiver operator characteristic curves showed a highly significant relation between the postprotamine CITF and intraoperative platelet and fresh frozen plasma transfusion (area under the curve, 0.78-0.81, P < 0.005) with 60-80% sensitivity, specificity, positive and negative predictive values at cutoffs of 12-14 min. Logistic regression demonstrated that the CITF was independently predictive of post-CPB hemostatic transfusion, but standard hemostatic assays were not. Conclusions The Clot Signature Analyzer CITF detects a clinical coagulopathic state after CPB and is independently predictive of the need for hemostatic transfusion. Hemostatometry has potential utility for monitoring hemostasis in cardiac surgery.

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