[Transfusion of fresh frozen plasma (FFP): audit of prescriptions].
OBJECTIVE
To review fresh frozen plasma (FFP) prescriptions and compare their validity to the legal french guidelines (law of the 12/03/91).


METHODS
Assessment of all prescriptions has been carried out by a multidisciplinary committee.


METHODS
All the adults transfused with FFP over one year in a teaching hospital.


METHODS
Following each head of department's agreement and following a written notice to all prescribers within the hospital to inform them of the undergoing study and its methodological validation by the board of quality experts, each delivery of FFP was followed by a questionnaire addressed to the prescriber. A board of experts then assessed the significance of the prescription in accordance with the legal requirements after reviewing each medical file.


RESULTS
144 prescriptions to 89 patients were assessed: 23% were judged inappropriate by the experts and 6% did not respect the law. The inappropriate transfusions distribute as follows: intensive care patients (73% of which 80% in multiple organ failure (MOF) and 20% in haemorrhagic shock), cirrhotic patients (12%), patients treated with vitamin K antagonists (12%), obstetric patients (3%). Nine percent of the appropriate transfusions were judged in insufficient volume. The hospital mortality rate was 48%. Among prescribers, 59% were not aware of the law.


CONCLUSIONS
A significant proportion of FFP transfusions is inappropriate. This study, which is the first step of a quality assurance program, will be followed by local recommendations for clinical practice. The current standards of prescribing FFP are more restrictive than those defined in the legal french guidelines.
Beloeil
H
H
Département d'anesthésie-réanimation, hôpital Antoine-Béclère, BP 405, 92141 Clamart, France.
Brosseau
M
M
Benhamou
D
D
D016913:Blood Component Transfusion / Q000331:legislation & jurisprudence / Q000592:standards*; D005602:France; D017408:Guidelines as Topic; D006801:Humans; D010949:Plasma; D055656:Prescriptions / Q000592:standards*; D011795:Surveys and Questionnaires