Background and Aims Bleeding and coagulopathy are common problems in sick neonates in intensive care. Fresh frozen plasma (FFP) is frequently transfused to correct coagulation abnormalities and for active bleeding. Evidence for the efficacy of this practice is limited. We conducted a retrospective review to see if there is an improvement in coagulation status in neonates transfused with FFP.
Method Retrospective study of neonates admitted to a tertiary neonatal unit who received FFP transfusion during a 5 year period (January 2003–March 2008).
Results 33 neonates received at least one FFP transfusion (range 1–3, total 44 transfusions). This cohort (18 male, 15 female) had a median gestational age of 29+4 weeks (range 23+1–41+4 weeks) and median weight of 1090 g (range 492–4300 g). 11 infants had co-existent thrombocytopenia (platelet count <100×109/L). 20 of the 33 infants (61%) died before discharge. The most common reason for transfusion was coagulopathy (17 transfusions); other indications included active bleeding (14), volume expansion (4), and surgical management (3). The duration of FFP transfusion ranged from 15–240 minutes (median: 60 minutes) and FFP volumes ranged from 10–20 mL/kg (median: 20 mL/kg). For infants with available pre and post (within 24 hours) transfusion coagulation studies (20 transfusions), there was no significant difference in PT (p = 0.2), APTT (p = 0.1) or fibrinogen levels (p = 0.2) resulting from the FFP transfusion.
Conclusions Although abnormalities of laboratory coagulation studies were the commonest reasons for transfusing FFP, no significant improvement in coagulation status was found in this patient group following FFP transfusion.