Published: 2021-04-28

Utilization of fresh frozen plasma in a tertiary care hospital in central Kerala

S. N. Sreelekshmi, Lekshmidevi ., G. Rajan, M. S. Suma


Background: The demand for blood and its components always exceeds the supply in our health care setting. Hence there is a need to prioritize the usage of these components. An audit makes this possible. The present study is conducted on utilization of Fresh frozen plasma which is one of the most requested blood components.

Methods: The study was conducted on the first 241 FFP transfusions during the study period of 1 year. Requisition forms for issuing FFP from various departments were reviewed and relevant data collected. Patients’ case record was also retrieved to collect data related to the transfusion episodes. The data collected were compiled, coded and expressed using descriptive statistical tools like mean, mode, percentage and ratio using Microsoft Excel 2010.

Results: Most of the patients who underwent FFP transfusion were males and in the age group 60-70. Most of the requests for FFP issue came from Cardiothoracic department. Most common indication for FFP transfusion was raised PT INR. FFP units remained unutilized in CTVS, General surgery and general medicine. 20% of the received request forms were incompletely filled with the Clinical diagnosis and Indication for FFP being most frequently omitted information.

Conclusions: Various departments at Government Medical College, Kottayam are efficiently utilizing FFP. But more intervention is needed in addressing issues related to the sending of requisition forms and ensuring adequate usage of FFP to prevent its wastage.


Fresh frozen plasma, Utilization, Transfusion

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Belayneh T, Messele G, Abdissa Z, Tegene B. Blood requisition and utilization practice in surgical patients at university of Gondar hospital, Northwest Ethiopia. Journal of Blood Transfusion. 2013;2013.

Silberstein LE, Kruskall MS, Stehling LC, Johnston MF, Rutman RC, Samia CT, et al. Strategies for the review of transfusion practices. JAMA. 1989;262(14):1993-7.

Friedman BA, Oberman HA, Chadwick AR, Kingdon KI. The maximum surgical blood order schedule and surgical blood use in United States. Transfusion (Paris). 1976;16(4):380-7.

Surgenor DM, Wallace EL, Hao SH, Chapman RH. Collection and transfusion of blood in the United States, 1982-1988. N Engl J Med. 1990;322(23):1646-51.

Choudhary R, Singh H, Verma A, Ray V. Evaluation of fresh frozen plasma usage at a tertiary care hospital in North India. ANZ J Surg. 2005;75(7):573-6.

AuBuchon JP. Blood transfusion options: improving outcomes and reducing costs. Arch Pathol Lab Med. 1997;121(1):40-7.

Prinja N, Sharma S, Narain R. Fresh frozen plasma utilization pattern in tertiary care hospital of North Western India. Int J Res Med Sci 2017;5:5372-5.

Bhagwat SN, Sharma JH. A retrospective audit of appropriateness and monitoring of fresh frozen plasma transfusions in a tertiary care hospital. International Journal Of Contemporary Medical Research. 2017;4(7):1562-7.

Trupti B, Farzana K, Milind D. Evaluation of fresh frozen plasma at a tertiary care hospital in Vadodara. Natl J Integr Res Med. 2017;8(2):99-102.

Kansay S, Verma M. Evaluation of request forms received in blood bank and biochemistry laboratory in a teaching hospital in North India: A comparative study of pre analytical errors. J Nat Accred Board Hosp Healthcare Providers. 2016;3:20-6.

Boral LI, Henry JB. The type and screen: a safe alternative and supplement in surgical procedures. Transfusion. 1977;17(2):163-8.

Mead JH, Anthony CD, Sattler M. Hemotherapy in elective surgery: An incidence report, review of literature and alternatives for guideline appraisal. A J Clin Pathol. 1980;74(2):223-7.

Chng WJ, Tan MK, Kupearn P. An audit of fresh frozen plasma usage in an acute general hospital in Singapore. Singapore Med J. 2003;44:574-8.

Hui CH, Williams I, Davis K. Clinical audit of the use of fresh-frozen plasma and platelets in a tertiary teaching hospital and the impact of a new transfusion request form. Int Med J. 2005;35:283-8.

Gaur DS, Negi H, Chauhan N, Kusum A, Khan S, Pathak VP. Utilization of blood and components in a tertiary care hospital . Indian J Hematol Blood Transfus. 2009;25:91-5.

Stanworth SJ, Grant-Casey J, Lowe D, Laffan M, New H, Murphy MF, et al. The use of fresh frozen plasma in England: high levels of inappropriate use in adults and children. Transfusion. 2011;51:62-70.

Shingare SA, Angarkar NN, Desai SR, Naniwadekar MR. An audit of fresh frozen plasma usage and effect of fresh frozen plasma on the pre – transfusion international normalized ratio. Asian J Transfus Sci. 2010;4:128-32.

Holland LL, Brooks JP. Toward rational fresh frozen plasma transfusion: the effect of plasma transfusion on coagulation test result. Am J Clin Pathol. 2006;126:133-9.

O’Shaughnessy DF, Atterbury C, Bolton MP. Guidelines for the use of fresh frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol. 2004;126:11-28.