Should plasma be transfused prophylactically before invasive procedures?
OBJECTIVE
Plasma transfusion to correct abnormal coagulation test results prior to an invasive procedure is a common clinical practice; however, there are no evidence-based guidelines. This review aims to analyze the most recent publications to either support or disprove such practice.


RESULTS
Due to heightened awareness of transfusion-related acute lung injury and volume overload in susceptible patients, clinicians are increasingly questioning the validity of prophylactic plasma transfusion. Recently, several articles, reviews and clinical studies (although small and poorly designed) have shown no benefit of prophylactic plasma transfusion in either correcting abnormal coagulation tests or reducing perceived risk of hemorrhage.


CONCLUSIONS
The use of sensitive reagents (especially for prothrombin time) has resulted in increased incidence of abnormal preprocedure coagulation screening test results - tests that are not designed to assess risk of bleeding in patients without a history of bleeding. Transfusion of plasma prior to an invasive procedure to correct mild to moderate abnormal test results neither corrects the abnormality nor reduces the perceived bleeding risk.
Holland
Lorne
L
Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, Texas 75390-9073, USA.
Sarode
Ravindra
R
D001778:Blood Coagulation Disorders / Q000097:blood / Q000628:therapy*; D016913:Blood Component Transfusion / Q000009:adverse effects*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006801:Humans; D019934:International Normalized Ratio; D010949:Plasma / Q000502:physiology; D011517:Prothrombin Time / Q000009:adverse effects / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative