Fresh frozen plasma transfusion in the neonatal population: A systematic review

Although fresh frozen plasma (FFP) transfusions are common practice in neonatology, robust evidence on their use is lacking. The aim of this study was to systematically review the literature for data on the practice of FFP transfusions in neonates and their association with neonatal morbidity and mortality.The authors identified 40 studies, which met the inclusion criteria for this review. It was demonstrated that the practice of FFP transfusions significantly varies throughout the world. The majority of FFP transfusions are administered prophylactically, without evidence of active bleeding. Although FFP transfusions may restore coagulation tests results, they do not alter the clinical outcome of the neonates. Reactions following transfusions are probably underestimated in neonates, often undiagnosed and thus, underreported. High quality RCTs aiming to evaluate the effectiveness of FFP in specific clinical conditions are urgently needed, as they could change long-standing FFP transfusion practices, and help reduce neonatal morbidity and mortality.

Automated summary

This study systematically reviewed the practice of fresh frozen plasma (FFP) transfusions in neonates and its association with neonatal morbidity and mortality. The results showed significant variations in FFP transfusion practices worldwide. The majority of FFP transfusions were administered prophylactically without evidence of active bleeding. Although FFP transfusions restored coagulation test results, they did not alter the clinical outcome of neonates. Additionally, reactions following transfusions were often underestimated and underreported in neonates. High quality randomized controlled trials are urgently needed to evaluate the effectiveness of FFP in specific clinical conditions and potentially change long-standing FFP transfusion practices to reduce neonatal morbidity and mortality.