Large amounts of frozen plasma are being used inappropriately, states a commentary in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj081933.pdf.
There has been increased attention given to the clinical use of red blood cells and platelets but not enough has been paid to the use of frozen plasma.
"Two recent studies in Canada found that 45% and 48% of audited frozen plasma transfusions represented inappropriate use, according to published guidelines," write Dr. Peter Pinkerton, Department of Clinical Pathology, Sunnybrook Health Sciences Centre, and coauthor. "The most common inappropriate use was in patients for whom there was no bleeding and laboratory coagulation test results were abnormal."
A list of appropriate and inappropriate reasons for the use of frozen plasma has been compiled from critical reviews and various published guidelines.
The authors conclude that measures should be introduced to improve practice, including promoting the use of available alternatives and prospective screening of orders for transfusion of frozen plasma against practice guidelines. Also, large retrospective audits could identify hospitals in particular need of assistance in improving practice.