Holland Lorne L, Brooks Jay P
Department of Pathology, University of Texas-Southwestern Medical Center, Dallas, TX 75390-9072, USA.
Am J Clin Pathol. 2006 Jul;126(1):133-9. doi: 10.1309/NQXH-UG7H-ND78-LFFK.
Numerous published guidelines encourage appropriate use of fresh frozen plasma (FFP). However, adherence is documented as poor. Therefore, we sought to determine the laboratory effect of FFP administration to patients with an international normalized ratio (INR) less than 1.6 (prothrombin time < 1.6 times normal). We found minimally prolonged INRs decreased with treatment of the underlying disease alone. Adding FFP to the treatment failed to change the decrease in INR over time. In addition, we observed that the change in the INR per unit of FFP transfused can be predicted by the pretransfusion INR (INR change = 0.37 [pretransfusion INR] - 0.47; r2 = 0.82). With an observed analytic variation of 3.2%, a significant amount of change in the INR following FFP transfusion is expected at an INR of more than 1.7. Indeed, only 50% of patients with an INR of 1.7 showed a significant change in INR with FFP transfusion. Therefore, transfusion for patients not meeting current FFP guidelines does not reliably reduce the INR and exposes patients to unnecessary risk.
众多已发表的指南鼓励合理使用新鲜冰冻血浆（FFP）。然而，据记载其依从性较差。因此，我们试图确定给国际标准化比值（INR）小于1.6（凝血酶原时间<正常的1.6倍）的患者输注FFP的实验室效应。我们发现，仅通过治疗基础疾病，轻度延长的INR就会降低。在治疗中添加FFP并不能改变INR随时间的下降情况。此外，我们观察到，每输注单位FFP后INR的变化可通过输血前INR预测（INR变化=0.37[输血前INR]-0.47；r2=0.82）。鉴于观察到的分析变异为3.2%，当INR大于1.7时，预计FFP输血后INR会有显著变化。实际上，INR为1.7的患者中只有50%在输注FFP后INR有显著变化。因此，给不符合当前FFP指南的患者输血并不能可靠地降低INR，反而会使患者面临不必要的风险。
