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FFP use protocol needed


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Dear colleagues! Greetings from Belarus! We're updating our clinical protocols. Please share with us your experience of Fresh Frozen Plasma (FFP) transfusion in non-surgical NICU. Do you use it only in case of bleeding, or bleeding and abnormal coagulation tests should be combined? Or abnormal tests alone is a good reason for FFP (e.g. in ELBW infants). What is bleeding -- fresh IVH III or minor pulmonary hemorrhage also matters? Which thresholds of coagulation tests you use? I've found useful paper on the issue. A table from it with coagulation parameters is attached to this post. Please have a look and tell briefly do you use the same numbers?  

Clin Perinatol. 2015 Sep;42(3):639-50. doi: 10.1016/j.clp.2015.04.013. Epub 2015 May 16.

Fresh Frozen Plasma Administration in the Neonatal Intensive Care Unit: Evidence-Based Guidelines.

Sincerely, Andrej Vitushka, NICU of National Research Center "Mother and Child", Minsk, Belarus.

FFP tab.doc

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Greetings from Sweden :)

First of all, I think I am biased by the very liberal practise of using FFP in the level-3 unit I trained in, we even referred to FFP as "Vitamin P" (as in Plasma). But times have changed to the better, i.e. a more sound and restrictive use.

ELBW - I would say most would give FFP on clearly abnormal coagulation tests alone, and of course, in cases of clinical scenaries like lung bleeds.

But of course, there are commonly situations when coagulations parameters are not so clearly pathological but also not within expected normal ranges -  if an infant is a candidate for hemodynamic fluid support, FFP is commonly choosen as the fluid.

I personally think the table is good, but we do not use PT but INR.

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