Use of fresh frozen plasma in patient treatment. Indications illustrated by a literature review and a study of practice at a university hospital

We analyzed transfusion data on all patients transfused with fresh frozen plasma (FFP) during two periods of four weeks, before (phase one) and after (phase two) initiation of information and intervention. Information was based on the results of phase one and on information about appropriate use of FFP. The intervention consisted of introducing a new policy: Clinicians had to justify their prescription of FFP to the physician on duty in the blood bank. During phase one, the usage of FFP was 403 units, which decreased to 229 units during phase two (43% reduction). In both phases an unchanged proportion of FFP units (68%) were preceded by coagulation tests. In phase one, only 90 (22.3%) of the instances had documented coagulopathy by laboratory criteria, whereas in phase two the number was 77 (33.6%). A total of 186 (46.4%) FFP units in phase one were considered inappropriately transfused compared to a total of 89 (38.9%) units in phase two. Indications for transfusion were stated for 80 (19.9%) FFP units during phase one increasing to 114 (49.8%) units during phase two. Through information and intervention we were able to reduce the usage of FFP by 43%. The results reveal a need for quality assurance of the use of transfusions with FFP.