Background Frozen Plasma (FP) and cryoprecipitate (Cryo) are frequently transfused to neonates although indications remain unclear. This survey aimed to characterize current UK neonatal FFP/Cryo transfusion practices.
Methods Pre-piloted 15 question survey developed by neonatologists and transfusion medicine specialists in UK, to include clinical scenarios and direct questions about FP/Cryo transfusion decisions. Survey was posted to all neonatal units (n=200 UK).
Results Response rate for UK was 53%, 42% Level 2, 25% level 3 and 12% level 1 units. 48% of clinicians, would consider using FP for volume expansion in a non-bleeding, non-coagulopathic infant with hypotension refractory to inotropes and crystalloids. In a clinical vignette describing the same case scenario, 11% of clinicians would use FP to raise oncotic pressure. 19% of neonatologists would use FP as an adjunct to diuresis in an infant with oedema, when other interventions failed, 5% of clinicians would order FP. For isolated abnormal haemostatic test results in the absence of bleeding, 21% of clinicians would give FP (irrespective of laboratory results), while 66% would order FP for clinical bleeding in the absence of coagulation results. When asked about volume of FP administered, 51% responded 10mls/kg, and 43% 15–20mls/kg. With respect to cryoprecipitate, 26% of respondents did not use this product.
Conclusions FP practice including dose is highly variable. Neonatologists are considering use of FP to expand volume and raise oncotic pressure. There is limited consideration of Cryo for transfusion. This survey highlights areas where evidence and education are essential to improve practice.