Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Clinical review: Fresh frozen plasma in massive bleedings - more questions than answers. | Nascimento et al. Critical Care 2010 14 202 http content 14 1 202 CRITICAL CARE REVIEW L_ Clinical review Fresh frozen plasma in massive bleedings - more questions than answers Bartolomeu Nascimento1 Jeannie Callum2 Gordon Rubenfeld3 Joao Baptista Rezende Neto4 5 Yulia Lin2 and Sandro Rizoli 5 Abstract Fresh frozen plasma FFP is indicated for the management of massive bleedings. Recent audits suggest physician knowledge of FFP is inadequate and half of the FFP transfused in critical care is inappropriate. Trauma is among the largest consumers of FFP Current trauma resuscitation guidelines recommend FFP to correct coagulopathy only after diagnosed by laboratory tests often when overt dilutional coagulopathy already exists. The evidence supporting these guidelines is limited and bleeding remains a major cause of trauma-related death. Recent studies demonstrated that coagulopathy occurs early in trauma. A novel early formula-driven haemostatic resuscitation proposes addressing coagulopathy early in massive bleedings with FFP at a near 1 1 ratio with red blood cells. Recent retrospective reports suggest such strategy significantly reduces mortality and its use is gradually expanding to nontraumatic bleedings in critical care. The supporting studies however have bias limiting the interpretation of the results. Furthermore logistical considerations including need for immediately available universal donor AB plasma short life after thawing potential waste and transfusion-associated complications have challenged its implementation. The present review focuses on FFP transfusion in massive bleeding and critically appraises the evidence on formula-driven resuscitation providing resources to allow clinicians to develop informed opinion given the current deficient and conflicting evidence. Introduction Fresh frozen plasma FFP is a blood product that has been available since 1941 1 . Initially used as a volume expander Correspondence
