title: Fresh frozen plasma use in the NICU: a prospective, observational, multicentred study.
abstract: OBJECTIVE
  To examine the use of fresh frozen plasma (FFP) in Italian neonatal intensive care units (NICUs); specifically to quantify compliance with guideline recommendations and to evaluate the relationship between coagulation tests and subsequent bleeding episodes.
  
  
  METHODS
  Prospective, observational study.
  
  
  METHODS
  Seventeen Italian NICUs.
  
  
  METHODS
  Over a period of 12 months, for all neonates that received FFP we recorded specific characteristics, pretransfusion and post-transfusion laboratory test of haemostasis, and details of all haemorrhagic events.
  
  
  RESULTS
  Among 3506 NICU admissions, 290 (8.2%) received one or more FFP transfusions during their hospital stay. Of these, 37% received FFP because of active bleeding and 63% received FFP prophylactically with the intention of preventing haemorrhage. A total of 609 FFP transfusions were administered (mean 2.1/transfused patient-range 1-25). Using previously agreed upon criteria, we judged that 60% of the 609 FFP transfusions were not compliant with guideline recommendations. By logistic regression, abnormalities in the prothrombin time, activated partial thromboplastin time, fibrinogen and platelet count were not independently associated with bleeding episodes.
  
  
  CONCLUSIONS
  FFP transfusion is a relatively frequent intervention in the NICU. In the present analysis, we found a remarkably high proportion of FFP transfusions given to non-bleeding neonates for indications not compliant with guideline recommendations. Platelet counts and coagulation studies were poor predictors of clinical bleeding.
authors.forename: Mario
authors.initials: M
authors.lastname: Motta
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Vecchio
authors.forename: Barbara
authors.initials: B
authors.lastname: Perrone
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghirardello
authors.forename: Maurizio
authors.initials: M
authors.lastname: Radicioni
mesh_terms: D001780:Blood Coagulation Tests / Q000379:methods; D016913:Blood Component Transfusion / Q000592:standards / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006470:Hemorrhage / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D006487:Hemostasis; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards / Q000706:statistics & numerical data*; D007558:Italy / Q000453:epidemiology; D010949:Plasma; D010976:Platelet Count; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D011517:Prothrombin Time; D018570:Risk Assessment / Q000379:methods