Puetz John, Darling Ginger, McCormick Kimberly A, Wofford Jonathan D
Division of Hematology/Oncology, Department of Pediatrics, Saint Louis University, SSM Cardinal Glennon Children's Medical Center, South Grand, St Louis, MO 63104, USA.
J Pediatr Hematol Oncol. 2009 Dec;31(12):901-6. doi: 10.1097/MPH.0b013e3181c29c25.
Little recent data are available describing fresh frozen plasma (FFP) use in neonates. The purpose of this study was to determine the outcomes of FFP transfusions in neonates.
A single institution, observational, and retrospective review of each transfusion of FFP given to neonates admitted to a neonatal intensive care unit over a 2-year period.
One hundred and seventy-three neonates were identified as having received FFP, giving a prevalence of FFP use at 12%. By far the most common determining factor for FFP use was an association with an abnormal activated partial thromboplastin time or prothrombin time (52%). Other factors included bleeding, invasive procedures, volume expansion, necrotizing enterocolitis, cardiopulmonary bypass, and hydrops fetalis. Of objectively accessible responses, FFP was able to correct abnormal coagulation tests into the normal range only 40% of the time. Twenty-four neonates received recombinant factor VIIa (rFVIIa) after first receiving FFP. The prevalence of thrombotic events was not higher in neonates receiving rFVIIa than those receiving FFP alone.
FFP was widely used in this neonatal unit. As data showing the predictive value of coagulation tests in neonates are discrepant, it is unclear if FFP was being appropriately used. Prospective, controlled data are required.
目前关于新生儿使用新鲜冰冻血浆（FFP）的近期数据较少。本研究的目的是确定新生儿FFP输血的结果。
对一家机构在两年期间内新生儿重症监护病房收治的新生儿接受的每次FFP输血进行单机构、观察性和回顾性研究。
173名新生儿被确定接受了FFP，FFP使用率为12%。到目前为止，使用FFP最常见的决定因素是与活化部分凝血活酶时间或凝血酶原时间异常有关（52%）。其他因素包括出血、侵入性操作、容量扩充、坏死性小肠结肠炎、体外循环和胎儿水肿。在可客观获取的反应中，FFP仅在40%的时间内能够将异常凝血试验纠正到正常范围。24名新生儿在首次接受FFP后接受了重组凝血因子VIIa（rFVIIa）。接受rFVIIa的新生儿血栓形成事件的发生率并不高于仅接受FFP的新生儿。
FFP在该新生儿病房广泛使用。由于显示新生儿凝血试验预测价值的数据存在差异，目前尚不清楚FFP的使用是否恰当。需要前瞻性对照数据。
