Venema D, Schut M, van Oers M H
Afd. Inwendige Geneeskunde, Academisch Medisch Centrum, Amsterdam.
Ned Tijdschr Geneeskd. 1998 Sep 5;142(36):1999-2002.
Evaluation of transfusion practice with regard to the guidelines for fresh frozen plasma.
Prospective.
Academic Medical Centre, department of internal medicine, Amsterdam, the Netherlands.
During 4 weeks in April-May 1996 the indication of every request for fresh frozen plasma was established by an inquiry by telephone and compared with the indications defined by the National organization for quality assurance in hospitals (CBO). To objectivate the stated indication it was checked whether laboratory tests had been performed (prothrombin time (PTT) and activated partial thromboplastin time (APTT), and if so, what the results were. Moreover, the numbers of transfused units of red cells, platelets and fresh frozen plasma in the first 24 hours were checked.
During the study period there were 195 requests for 844 units of plasma. 613 units were transfused in 100 patients. If the CBO guidelines were applied strictly, the proportions of plasma units inappropriately requested and inappropriately administered were 53% and 47% respectively (in 32 patients). If the CBO indications were applied less strictly, still 25% of the units were inappropriately requested and 18% inappropriately administered (in 23 patients).
The guidelines were observed only moderately. Better compliance is important for medical, logistic and financial reasons.
根据新鲜冰冻血浆指南评估输血实践。
前瞻性研究。
荷兰阿姆斯特丹学术医疗中心内科。
在1996年4月至5月的4周内，通过电话询问确定每一份新鲜冰冻血浆申请的指征，并与医院质量保证国家组织（CBO）定义的指征进行比较。为了使所述指征客观化，检查是否进行了实验室检测（凝血酶原时间（PTT）和活化部分凝血活酶时间（APTT）），如果进行了检测，结果如何。此外，还检查了前24小时内输注的红细胞、血小板和新鲜冰冻血浆的单位数量。
在研究期间，有195份申请，共844单位血浆。100名患者输注了613单位。如果严格应用CBO指南，不适当申请和不适当使用的血浆单位比例分别为53%和47%（32名患者）。如果不太严格地应用CBO指征，仍有25%的单位申请不当，18%使用不当（23名患者）。
对指南的遵守情况一般。出于医学、后勤和财务原因，更好地遵守指南很重要。
