Factors influencing plasma transfusion practices in paediatric intensive care units around the world.

Published

Journal Article

BACKGROUND AND OBJECTIVES: Plasma transfusions are a frequent treatment worldwide, but many studies have reported a wide variation in the indications to transfuse. Recently, an international paediatric study also showed wide variation in frequency in the use of plasma transfusions: 25% of the centres transfused plasma to >5% of their patients, whereas another 25% transfused plasma to <1% of their patients. The objective of this study was to explore the factors associated with different plasma transfusion practices in these centres. MATERIALS AND METHODS: Online survey sent to the local investigators of the 101 participating centres, in February 2016. Four areas were explored: beliefs regarding plasma transfusion, patients' case-mix in each unit, unit's characteristics, and local blood product transfusion policies and processes. RESULTS: The response rate was 82% (83/101). 43% of the respondents believed that plasma transfusions can arrest bleeding, whereas 27% believe that plasma transfusion can prevent bleeding. Centres with the highest plasma transfusion rate were more likely to think that hypovolaemia and mildly abnormal coagulation tests are appropriate indications for plasma transfusions (P = 0·02 and P = 0·04, respectively). Case-mix, centre characteristics or local transfusion services were not identified as significant relevant factors. CONCLUSION: Factors influencing plasma transfusion practices reflect beliefs about indications and the efficacy of transfusion in the prevention and management of bleeding as well as effects on coagulation tests. Educational and other initiatives to target these beliefs should be the focus of research.

Full Text

Duke Authors

Cited Authors

  • Karam, O; Demaret, P; Duhamel, A; Shefler, A; Spinella, PC; Tucci, M; Leteurtre, S; Stanworth, SJ; PlasmaTV investigators,

Published Date

  • February 2017

Published In

Volume / Issue

  • 112 / 2

Start / End Page

  • 140 - 149

PubMed ID

  • 28176380

Pubmed Central ID

  • 28176380

Electronic International Standard Serial Number (EISSN)

  • 1423-0410

Digital Object Identifier (DOI)

  • 10.1111/vox.12490

Language

  • eng

Conference Location

  • England