Department of Pathology, University of Maryland Medical Center, Baltimore, MD, USA.
Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA.
Am J Clin Pathol. 2022 Jul 1;158(1):148-152. doi: 10.1093/ajcp/aqac020.
Previous studies of blood product use have shown higher inappropriate use of plasma compared with other products. Given typical weight-based dosing of plasma, we hypothesized that single plasma transfusions in adults would either be a nontherapeutic dose or outside clinical guidelines.
A single-center, retrospective review of nonoperative, nonapheresis plasma use was conducted from January 2020 to April 2020. Plasma transfusions were reviewed for compliance with clinical guidelines formulated at our institution as well as national and society guidelines.
During the study period, 313 units of plasma were transfused. Of these, 152 (48.6%) were given against institutional or national guidelines, 126 plasma units (40.3%) were transfused as single units, and 187 (59.7%) were given as part of multiple-unit transfusions. All single-unit plasma transfusions during the study period were either underdosed or outside clinical guidelines. Units transfused with an indication of "Other" were significantly more likely to be outside clinical guidelines.
Nonoperative, nonapheresis plasma use is often outside clinical guidelines. Single-unit plasma transfusions in adults are a potential target for patient blood management programs seeking to minimize unnecessary plasma use.
先前的血液制品使用研究表明，与其他产品相比，血浆的不合理使用更高。鉴于血浆通常基于体重给药，我们假设成人单次输注血浆的剂量要么是非治疗性的，要么超出了临床指南的规定。
对 2020 年 1 月至 4 月期间非手术、非血浆分离术的血浆使用进行了单中心回顾性研究。对血浆输注是否符合我院以及国家和社会制定的临床指南进行了审查。
在研究期间，输注了 313 单位的血浆。其中，152 个（48.6%）单位的输注不符合机构或国家指南，126 个（40.3%）单位的血浆作为单剂量输注，187 个（59.7%）单位作为多剂量输注的一部分。在研究期间，所有单次输注的血浆都剂量不足或超出了临床指南。带有“其他”指征的单位更有可能不符合临床指南。
非手术、非血浆分离术的血浆使用常常不符合临床指南。对于旨在尽量减少不必要的血浆使用的患者血液管理计划来说，成人单次输注血浆可能是一个潜在的目标。
