Indications and Effects of Plasma Transfusions in Critically Ill Children

Plasma transfusions are frequently prescribed for critically ill children, although their indications lack a strong evidence base. Many physicians often transfuse critically ill children who have abnormal coagulation tests and who are not bleeding. Karam et al conducted an international multicenter observational point-prevalence study involving 101 pediatric intensive care units in 21 countries. They sought to characterize indications leading to plasma transfusions in critically ill children and assess the effect of plasma transfusions on coagulation tests.

They found that approximately one-third of transfused patients were not bleeding and had no planned procedure. In addition, in most patients, coagulation tests were not sensitive to increases in coagulation factors resulting from plasma transfusion.

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