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Population-based audit of fresh-frozen plasma transfusion practices

Authors

  • Riikka Palo,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Leena Capraro,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Seppo Hovilehto,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Merja Koivuranta,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Tom Krusius,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Elina Loponen,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Ritva Mäntykoski,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Jussi Pentti,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Otto Pitkänen,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Maria Raitakari,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Jussi Rimpiläinen,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Markku Salmenperä,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Hanna Salo,

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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  • Tiina Mäki

    1. From the Finnish Red Cross Blood Service, Helsinki; the Health Care District of Central Finland, Jyväskylä; the Hospital District of Helsinki and Uusimaa, Helsinki and Hyvinkää; the Hospital District of Kymenlaakso, Kotka; the Hospital District of Northern Ostrobothnia, Oulu; the Hospital District of Northern Savo, Kuopio; the Hospital District of Satakunta, Pori; the Hospital District of Southern Savo, Mikkeli; and the Hospital District of South Karelia, Lappeenranta Finland.
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Riikka Palo, Hospital District of Helsinki and Uusimaa, Meilahti Hospital, Department of Anesthesia and Intensive Care, Haartmaninkatu 4, FI-00029 HUS, Helsinki, Finland; e-mail: riikka.palo@hus.fi, rpalo@welho.com.

Abstract

BACKGROUND: In contrast to decreasing red blood cell (RBC) consumption in Finland, the use of fresh-frozen plasma (FFP) has been increasing since the 1990s, suggesting that FFP use may not always be optimal. To improve transfusion practices, knowledge of current FFP use and regional, national, and international comparison is necessary.

STUDY DESIGN AND METHODS: Nine (of 21) Finnish hospital districts participated. Data concerning FFP-transfused patients in the years 2002 and 2003 were collected from existing computerized medical records into a yearly updated database as part of a Finnish benchmarking project on blood component use.

RESULTS: Data included 11,590 FFP-transfused patients and 60,240 FFP units (71.2% of Finnish FFP use) delivered to Finnish hospitals during the study period. FFP was transfused most often to surgery patients (62.8% of FFP transfusion hospital visits) with blood circulatory system problems (32.3% of surgically treated and FFP-transfused patients). In only 65.9 percent of FFP-transfused patients were coagulation variables measured at any point in the hospital episode, and FFP was usually transfused in paired doses. Mean FFP use in Finland is comparable to other countries.

CONCLUSION: Although overall FFP use in Finland is similar to that of international figures, it does not ensure best practice. Perioperative staff, being the largest FFP user, should be encouraged to dose FFP based on coagulation variables and body weight. Improvement efforts should be directed to patient groups transfused with large amounts of FFP.

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