title: Inappropriateness of fresh frozen plasma for abnormal coagulation tests.
abstract: BACKGROUND
  There is increasing evidence to suggest that the use of fresh frozen plasma (FFP) as a prophylaxis to bleeding is ineffective. However, a high proportion of FFP transfusions still occur in non-bleeding patients despite the high risk of adverse events. The aim of the study was to assess compliance with current prophylactic FFP guidelines at a large tertiary centre.
  
  
  METHODS
  Data were collected retrospectively over a 16-month period from May 2010 to August 2011. Information collected included patient characteristics, indications for and details of FFP use, and the ordering of coagulation screens before and after transfusion.
  
  
  RESULTS
  Over this period, FFP was used in a total of 573 transfusion episodes, 88 of which were prophylactic. This use deviated from the British Committee for Standards in Haematology guidelines in three main areas: indications for FFP use (89%), dose prescribed (49%) and the measurement of prothrombin time (PT) and activated partial thromboplastin time (APTT) after transfusion (66%).
  
  
  CONCLUSIONS
  There were no significant differences in compliance with guidelines between different hospital departments, suggesting a culture of widespread inappropriate FFP use and a general lack of understanding among clinicians. Physician training and increased enforcement of existing guidelines could reduce FFP usage and expenditure.
authors.affiliation: School of Medicine, University of Liverpool, Liverpool, UK.
authors.forename: S
authors.initials: S
authors.lastname: Pybus
authors.forename: A
authors.initials: A
authors.lastname: MacCormac
authors.forename: A
authors.initials: A
authors.lastname: Houghton
authors.forename: V
authors.initials: V
authors.lastname: Martlew
authors.forename: J
authors.initials: J
authors.lastname: Thachil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D001780:Blood Coagulation Tests; D016913:Blood Component Transfusion / Q000009:adverse effects; D005260:Female; D019983:Guideline Adherence; D006470:Hemorrhage / Q000517:prevention & control*; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D010949:Plasma; D017410:Practice Guidelines as Topic; D011517:Prothrombin Time; D011787:Quality of Health Care; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult