Factors influencing plasma transfusion practices in paediatric intensive care units around the world

Journal article


Karam, O, Demaret, P, Duhamel, A, Shefler, A, Spinella, PC, Tucci, M, Leteurtre, S and Stanworth, SJ (2017). Factors influencing plasma transfusion practices in paediatric intensive care units around the world. Vox Sanguinis. 112 (2), pp. 140-149.
AuthorsKaram, O, Demaret, P, Duhamel, A, Shefler, A, Spinella, PC, Tucci, M, Leteurtre, S and Stanworth, SJ
Abstract

© 2017 International Society of Blood Transfusion Background and Objectives: Plasma transfusions are a frequent treatment worldwide, but many studies have reported a wide variation in the indications to transfuse. Recently, an international paediatric study also showed wide variation in frequency in the use of plasma transfusions: 25% of the centres transfused plasma to > 5% of their patients, whereas another 25% transfused plasma to < 1% of their patients. The objective of this study was to explore the factors associated with different plasma transfusion practices in these centres. Materials and Methods: Online survey sent to the local investigators of the 101 participating centres, in February 2016. Four areas were explored: beliefs regarding plasma transfusion, patients’ case-mix in each unit, unit’s characteristics, and local blood product transfusion policies and processes. Results: The response rate was 82% (83/101). 43% of the respondents believed that plasma transfusions can arrest bleeding, whereas 27% believe that plasma transfusion can prevent bleeding. Centres with the highest plasma transfusion rate were more likely to think that hypovolaemia and mildly abnormal coagulation tests are appropriate indications for plasma transfusions (P = 0·02 and P = 0·04, respectively). Case-mix, centre characteristics or local transfusion services were not identified as significant relevant factors. Conclusion: Factors influencing plasma transfusion practices reflect beliefs about indications and the efficacy of transfusion in the prevention and management of bleeding as well as effects on coagulation tests. Educational and other initiatives to target these beliefs should be the focus of research.

KeywordsPlasmaTV investigators; Humans; Hemorrhage; International Normalized Ratio; Partial Thromboplastin Time; Blood Component Transfusion; Adult; Physicians; Intensive Care Units, Pediatric; Female; Male; Surveys and Questionnaires; blood component transfusion; child; critical illness; plasma; Adult; Blood Component Transfusion; Female; Hemorrhage; Humans; Intensive Care Units, Pediatric; International Normalized Ratio; Male; Partial Thromboplastin Time; Physicians; Surveys and Questionnaires; 1103 Clinical Sciences; Cardiovascular System & Hematology
Year2017
JournalVox Sanguinis
Journal citation112 (2), pp. 140-149
PublisherLondon South Bank University
ISSN0042-9007
Digital Object Identifier (DOI)doi:10.1111/vox.12490
Publication dates
Print07 Feb 2017
Publication process dates
Deposited07 Jun 2018
Accepted28 Dec 2016
Accepted author manuscript
License
CC BY-NC 4.0
ContributorsStephen, McKeever
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https://openresearch.lsbu.ac.uk/item/8707v

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