An audit of fresh frozen plasma usage in children in a tertiary care hospital in western india

Introduction: Fresh frozen plasma (FFP) is a blood component which is being used as a rational replacement therapy for various clinical conditions. Many of the times FFP being used irrationally and associated with a variety of hazards. Because of ease of availability and gap in the knowledge of medical professionals blood products are being used liberally and sometimes inappropriately. Methodology: Prospective cross sectional observational study was done over a period of 1 year in a tertiary hospital, in the western part of India. 100 events of FFP therapy was studied in neonates (< 1month) and pediatric (1month-16years)age groups. Indications and reactions to transfusion of FFP were studied in both the groups and its indication was compared with BCHS guidelines for terming it as appropriate or inappropriate. Results: Out of total 100 events of transfusions majority of the transfusions was in age group of 1 to 5 yrs (44%), most common indication being sepsis. In the pediatric age group 58% of the transfusions were done in ICU, We found that overall 36 % FFP transfusions were Inappropriate. Use of FFP for volume expansion was the most frequent form of inappropriate use followed by cases of bleeding without derangement of coagulation tests. Increasing awareness among the clinicians and strict protocol in management may have helped to reduce the percentage of inappropriate transfusions. Overall 3.0% had transfusion reactions, commonest being had FNHTR. Conclusion: Regular audit of blood and its component usage is essential to assess the blood utilization pattern and set ideal policies in all the medical specialties to make it appropriate, ensure availability and save patients from its hazards.