Infusion Ups Risk of Organ Failure in Trauma Patients

In critically injured patients, FFP, but not platelets, found to be independent risk factor
By Lindsey Marcellin
HealthDay Reporter

THURSDAY, Oct. 21 (HealthDay News) -- Early transfusion of fresh frozen plasma (FFP) is associated with an increased risk of post-injury multiple organ failure (MOF), according to research published in the October issue of the Archives of Surgery.

Jeffrey L. Johnson, M.D., of the University of Colorado Denver, and colleagues conducted a prospective cohort study of 1,440 critically injured patients admitted to a surgical intensive care unit who survived for at least 48 hours.

The researchers found that MOF developed in 24 percent of patients, while 8.2 percent died. Multiple logistic regression analysis detected a significant interaction between units of FFP and packed red blood cells (PRBCs) transfused, but units of FFP independently predicted the development of MOF. The worst effects of FFP transfusion were seen in patients who had received fewer than six units of PRBCs. There was no association found between platelet infusion and mortality after adjustment for other pertinent factors.

"Further delineation of the precise post-injury changes in the clotting and fibrinolysis cascades is required before a scientific basis for FFP transfusion can be established," the authors conclude. "In the interim, although FFP remains a tool in the bloody vicious cycle, it would seem wise to proceed with caution."

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