Fresh Frozen Plasma Use in a Neonatal Unit in South Africa

SUMMARY Background: Despite limited evidence, fresh frozen plasma (FFP) transfusions are a relatively common neonatal procedure. Objectives: Quantify FFP usage in our unit; determine indications for transfusions and compliance with published guidelines. Methods: Data were retrospectively collected on infants who received FFP from January 2009 to December 2013. Results: Admissions totalled 10 912 infants during the study period. In total, 113 case notes were reviewed and 142 FFP transfusions were administered. Infants receiving FFP had a high mortality rate (54.87%) and an increased odds ratio for mortality 17.9 (95% confidence interval 12.0–26.6). In total, 75% FFP transfusions were compliant with guidelines. The difference between pre- and post-transfusion coagulation profile in 36.3% of infants was not statistically significant. Conclusions: FFP was often used in accordance with published guidelines in our neonatal unit. However, the appropriate use and effectiveness of FFP in improving neonatal outcomes undermines the rationale for FFP usage in current guidelines.