Lahrmann C, Højlund K, Kristensen T, Georgsen J
Klinisk immunologisk afdeling, Odense Universitetshospital.
Ugeskr Laeger. 1996 Jun 10;158(24):3467-70.
We analyzed transfusion data on all patients transfused with fresh frozen plasma (FFP) during two periods of four weeks, before (phase one) and after (phase two) initiation of information and intervention. Information was based on the results of phase one and on information about appropriate use of FFP. The intervention consisted of introducing a new policy: Clinicians had to justify their prescription of FFP to the physician on duty in the blood bank. During phase one, the usage of FFP was 403 units, which decreased to 229 units during phase two (43% reduction). In both phases an unchanged proportion of FFP units (68%) were preceded by coagulation tests. In phase one, only 90 (22.3%) of the instances had documented coagulopathy by laboratory criteria, whereas in phase two the number was 77 (33.6%). A total of 186 (46.4%) FFP units in phase one were considered inappropriately transfused compared to a total of 89 (38.9%) units in phase two. Indications for transfusion were stated for 80 (19.9%) FFP units during phase one increasing to 114 (49.8%) units during phase two. Through information and intervention we were able to reduce the usage of FFP by 43%. The results reveal a need for quality assurance of the use of transfusions with FFP.
我们分析了在两个为期四周的时间段内所有输注新鲜冰冻血浆（FFP）患者的输血数据，一个时间段是在信息与干预措施启动之前（第一阶段），另一个时间段是在启动之后（第二阶段）。信息基于第一阶段的结果以及有关FFP合理使用的信息。干预措施包括引入一项新政策：临床医生必须向血库值班医生说明其FFP处方的理由。在第一阶段，FFP的使用量为403单位，在第二阶段降至229单位（减少了43%）。在两个阶段中，进行凝血试验的FFP单位比例均保持不变（68%）。在第一阶段，只有90例（22.3%）通过实验室标准记录有凝血病，而在第二阶段这一数字为77例（33.6%）。与第二阶段的89例（38.9%）相比，第一阶段共有186例（46.4%）FFP单位被认为输注不当。在第一阶段，80例（19.9%）FFP单位说明了输血指征，在第二阶段增加到114例（49.8%）。通过信息与干预，我们能够将FFP的使用量减少43%。结果表明需要对FFP输血的使用进行质量保证。
