Iorio Alfonso, Basileo Michela, Marchesini Emanuela, Materazzi Mario, Marchesi Mauro, Esposito Antonella, Palazzesi Gian Paolo, Pellegrini Lucio, Pasqua Barbara Luciani, Rocchetti Lauretta, Silvani Carla Maria
Medicina Interna e Vascolare, Università di Perugia, Italy.
Blood Transfus. 2008 Jan;6(1):18-24. doi: 10.2450/2008.0041-07.
The clinical use of fresh-frozen plasma (FFP) is progressively increasing both nationally and internationally, despite the fact that many studies have shown the weaknesses of the indications for its use. Guidelines on the good use of plasma have, therefore, been adopted in various countries. The aim of the present study was to analyse some of the existing guidelines on the good use of plasma, applying a scientifically validated method, as a preliminary step in the implementation of Regional guidelines.
Abibliographic search (1990-2006) was conducted in databases, websites, and the archives of scientific societies. Relevant articles were recovered in full. The selected guidelines were evaluated using theAGREE instrument, which assesses the completeness and structural quality of the guidelines and, in some aspects, the contents of the recommendations. The project, co-ordinated by the Regional Centre for Co-ordination and Compensation (CRCC) and carried out by four Services of Immunohaematology and Transfusion (SIT) in Umbria, was funded by the Region of Umbria and approved by the four health care institutions involved.
The bibliographic search yielded 3067 abstracts of which 239 were considered relevant. The analysis of these led to the recovery of 11 guidelines, among which five were selected: those from the British Committee for Standards in Haematology, theAgence Française de Securité Sanitaire de Produits de Sante, the Canadian Members of the Expert Working Group, the American Society of Anesthesiologists Task Force on Blood Component Therapy and the National Health and Medical Research Council (NHMRC)/Australasian Society of Blood Transfusion.
None of the guidelines analysed obtained a score higher than 50% in all the domains of the AGREE score. There was no evidence of a tendency to improvement over time in the guidelines analysed. Objective evaluation of the guidelines analysed could provide the starting point for the subsequent production of similar documents.
尽管许多研究已表明新鲜冰冻血浆（FFP）的使用指征存在缺陷，但在国内和国际上，其临床应用仍在逐步增加。因此，各国已采用血浆合理使用指南。本研究的目的是应用科学验证的方法分析现有的一些血浆合理使用指南，作为实施地区指南的初步步骤。
在数据库、网站和科学协会档案中进行文献检索（1990 - 2006年）。全文获取相关文章。使用AGREE工具对所选指南进行评估，该工具评估指南的完整性和结构质量，以及在某些方面的推荐内容。该项目由地区协调与补偿中心（CRCC）协调，由翁布里亚的四个免疫血液学和输血服务部门（SIT）实施，由翁布里亚地区资助，并得到四个相关医疗机构的批准。
文献检索得到3067篇摘要，其中239篇被认为相关。对这些摘要的分析导致找回11份指南，从中选择了5份：英国血液学标准委员会、法国卫生安全产品局、加拿大专家工作组成员、美国麻醉医师协会血液成分治疗特别工作组以及国家卫生与医学研究委员会（NHMRC）/澳大利亚输血协会的指南。
在AGREE评分的所有领域中，所分析的指南均未获得高于50%的分数。在所分析的指南中，没有证据表明随着时间推移有改进的趋势。对所分析指南的客观评估可为后续编写类似文件提供起点。
