Impact of plasma transfusion in trauma patients who do not require massive transfusion.

The article by Inaba et al. is a retrospective observational single-center study assessing the impact of FFP transfusion on morbidity and mortality in non-massively transfused trauma patients from 2000 to 2005. Patients receiving FFP transfusion within the first 12 h from admission were compared to those who did not using propensity score matching (n = 468).

No improvement in survival with plasma transfusion (17% versus 14%; p = 0.30) was found, whereas the overall complication rate was significantly higher for patients receiving plasma (27% versus 18%, OR = 1.7; 95% CI, 1.1-2.4; p = 0.016). An increase in complications with the increase in FFP volume transfused was seen, reaching 37% for patients receiving > 6 U. Patients receiving > 6 U plasma had a 12-fold increase in ARDS, a 6-fold increase in multiple organ dysfunction syndrome, and a 4-fold increase in pneumonia and sepsis.

The present manuscript adds to the growing body of reports indicating that caution with FFP transfusion may be beneficial, especially in non-massively transfused patients. Randomized clinical studies, however, are highly warranted.

– Pär Johansson