Tuesday April 15, 2008
Transfusion of FFP in critically ill surgical patients is associated with an increased risk of infection

We have previous studies documenting increased risk of nosocomial Infection with allogenic packed red blood cell transfusion 1. This month one retrospective study published in Critical Care Medicine shows that, also transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection 2.
Patients: A total of 380 non-trauma patients who received fresh frozen plasma from 2004 to 2005 were compared with 2,058 nontrauma patients who did not receive fresh frozen plasma.
Results: A significant association was found between transfusion of fresh frozen plasma and

• ventilator-associated pneumonia with shock,
• ventilator-associated pneumonia without shock,
• bloodstream infection with shock,
• undifferentiated septic shock
• The relative risk for transfusion of fresh frozen plasma and all infections was 2.99
• The t-test revealed a significant dose-response relationship between fresh frozen plasma and infectious complications
• Chi-square analysis showed a significant association between infection and transfusion of fresh frozen plasma in patients who did not receive concomitant red blood cell transfusion but this association was not significant in those who did receive red blood cells in addition to fresh frozen plasma.
• The association between fresh frozen plasma and infectious complications remained significant in the multivariate model, with an odds ratio of infection per unit of fresh frozen plasma transfused equal to 1.039. This odds ratio resembled that noted for each unit of packed red blood cells, 1.074
  
  

Conclusions: Transfusion of fresh frozen plasma is associated with an increased risk of infection in critically ill patients.

References: click to get abstract

1. Impact of allogenic packed red blood cell transfusion on nosocomial infection rates in the critically ill patient - Critical Care Medicine. 30(10):2249-2254, October 2002

2. Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection - Critical Care Medicine. 36(4):1114-1118, April 2008.