Rational use of FFP at North Colombo Teaching Hospital: An audit

Abstract

INTRODUCTION & OBJECTIVES: The British Committee for Standards in Haematology (BCSH) provides guidelines for use of fresh frozen plasma (FFP). Inappropriate use and non-compliance with guidelines for FFP have been reported.This audit is to reinforce guidelines and avoid inappropriate use. The objectives are to check - l.The indications ofFFP use 2.Calculation of dose according to weight of patient 3.Checking of coagulation (PT/APTT) before and after FFP METHODS: Data was collected from blood bank requests for 4 months. Details were collected from a questionnaire from patients and BHTs following transfusion.RESULTS: Of 50 patients, 11 were neonates and 4 children. Indications were liver disease with abnormal coagulation (40%), DIC and severe sepsis (20%), liver disease with normal coagulation awaiting surgery (10%), and massive bleeding (8%). 14% of neonates required FFP for resuscitation and to treat sepsis.Though weight was measured in 41(82%), adequate dose was administered to 14 (28%), overestimated in 26%, and underestimated in 28%. Pre and post transfusion coagulation was done in 33 (66%) and 17 (34%) respectively. Seven (14%) had coagulation tests within 3 hours. None of the patients had informed consent, risks and benefits informed prior to transfusion. CONCLUSION: All FFP is used according to guidelines. Documentation of volume of FFP used requires improvement as ambiguity of ml or units. Each unit of FFP varies· from 180ml - 230ml. Requirement of post transfusion coagualation within 3 hours is to be emphasized. Requirement of informed consent prior to transfusion of blood products is stressed.