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1دورية أكاديمية
المؤلفون: Mirzamani, N.1,2 nedamir19@yahoo.com, Molana, A.1,2, Poorani, E.1,2
المصدر: Transfusion & Apheresis Science. Apr2009, Vol. 40 Issue 2, p109-113. 5p.
مصطلحات موضوعية: *FROZEN blood, *BLOOD coagulation factors, *BLOOD coagulation disorders, *BLOOD coagulation tests, *MEDICAL practice, *HEMATOLOGY
مصطلحات جغرافية: IRAN
مستخلص: Abstract: Background: Fresh frozen plasma (FFP) is a major source of coagulation factor replacement therapy for patients with clotting factor deficiency. Although FFP is readily available for use in clinical practice its administration isn’t without risk. Studies on the use of FFP reveal that it is often overused or inappropriately used. We undertook an audit to assess the appropriateness of FFP transfusion in Gorgan’s hospitals. Methods: This was a retrospective, audit done at 5 hospitals in Gorgan city regarding the use of 1592 units of FFP issued to 346 patients from March 2006 to March 2007. The appropriateness of FFP transfusion was analyzed according to British Council for Standardization in Hematology (BCSH) Guidelines 2004. Results: In this audit we identified a high rate of inappropriate FFP usage (53% of transfusion episodes). Most ‘Inappropriate’ FFP usage occurred when there was active bleeding, with normal (or unmeasured) coagulation tests (30% of transfusion episodes). In only 66% of FFP-transfused patients were coagulation variable measured at any point in the hospital episode. Conclusion: Inappropriate usage of FFP is often seen in medical facility and the right solution is needed to curb the misuse of this component. Regular utilization audit can identify correctable errors in transfusion practices. Formal education programs and existing information on FFP use should be directed to professionals ordering FFP. [Copyright &y& Elsevier]
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2دورية أكاديمية
المصدر: British Journal of Haematology; Jul2004, Vol. 126 Issue 1, p139-152, 14p
مصطلحات موضوعية: CLINICAL trials, BLOOD transfusion, FROZEN blood, CLINICAL medicine, INTERNAL medicine, HEMATOLOGY
مستخلص: Randomized controlled trials of good quality are a recognized means to robustly assess the efficacy of interventions in clinical practice. A systematic identification and appraisal of all randomized trials involving fresh frozen plasma (FFP) has been undertaken in parallel to the drafting of the updated British Committee for Standards in Haematology guidelines on the use of FFP. A total of 57 trials met the criteria for inclusion in the review. Most clinical uses of FFP, currently recommended by practice guidelines, are not supported by evidence from randomized trials. In particular, there is little evidence for the effectiveness of the prophylactic use of FFP. Many published trials on the use of FFP have enrolled small numbers of patients, and provided inadequate information on the ability of the trial to detect meaningful differences in outcomes between the two patient groups. Other concerns about the design of the trials include the dose of FFP used, and the potential for bias. No studies have taken adequate account of the extent to which adverse effects might negate the clinical benefits of treatment with FFP. There is a need to consider how best to develop new trials to determine the efficacy of FFP in different clinical scenarios to provide the evidence base to support national guidelines for transfusion practice. Trials of modified FFP (e.g. pathogen inactivated) are of questionable value when there is little evidence that the standard product is an effective treatment. [ABSTRACT FROM AUTHOR]
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