Raval Jay S, Waters Jonathan H, Triulzi Darrell J, Yazer Mark H
Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. ; The Institute for Transfusion Medicine, Pittsburgh, PA, USA.
Korean J Hematol. 2012 Dec;47(4):298-301. doi: 10.5045/kjh.2012.47.4.298. Epub 2012 Dec 24.
Plasma is used to correct coagulopathies, but not all coagulation abnormalities are clinically significant enough to require correction before an invasive procedure. We report an 82 year old female who, in response to a mildly prolonged INR of unknown etiology, was unnecessarily transfused with plasma in advance of elective surgery. The patient suffered a moderately severe transfusion reaction, including hives and voice hoarseness, which caused a 4-week delay in her surgery. This delay and adverse reaction could have been avoided had the principles of evidence based plasma therapy, which we herein review, been followed and if the etiology of the mildly elevated INR been investigated before the day of her surgery.
血浆用于纠正凝血障碍，但并非所有凝血异常在临床上都严重到需要在侵入性操作前进行纠正。我们报告了一名82岁女性，因不明原因的国际标准化比值（INR）轻度延长，在择期手术前不必要地输注了血浆。患者发生了中度严重的输血反应，包括荨麻疹和声音嘶哑，导致手术推迟了4周。如果遵循我们在此回顾的循证血浆治疗原则，并在患者手术当天之前对INR轻度升高的病因进行调查，这种延迟和不良反应本可避免。
