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Annals of Intensive Care

, 3:16

First Online: 02 June 2013Received: 25 February 2013Accepted: 07 May 2013


Whereas red blood cell transfusions have been used since the 19th century, plasma has only been available since 1941. It was originally mainly used as volume replacement, mostly during World War II and the Korean War. Over the years, its indication has shifted to correct coagulation factors deficiencies or to prevent bleeding. Currently, it remains a frequent treatment in the intensive care unit, both for critically ill adults and children. However, observational studies have shown that plasma transfusion fail to correct mildly abnormal coagulation tests. Furthermore, recent epidemiological studies have shown that plasma transfusions are associated with an increased morbidity and mortality in critically ill patients. Therefore, plasma, as any other treatment, has to be used when the benefits outweigh the risks. Based on observational data, most experts suggest limiting its use either to massively bleeding patients or bleeding patients who have documented abnormal coagulation tests, and refraining for transfusing plasma to nonbleeding patients whatever their coagulation tests. In this paper, we will review current evidence on plasma transfusions and discuss its indications.

KeywordsPlasma transfusion Plasma products Clinical effects of plasma AbbreviationsALIAcute lung injury

aPTTActivated partial thromboplastin time

ARDSAcute respiratory distress syndrome

DICAcute disseminated intravascular coagulation

FFPFresh-frozen plasma

FPFrozen plasma

HIVHuman immunodeficiency virus

HLAHuman leucocyte antigen


INRInternational normalized ratio

PRPPathogen reduced plasmas

PTProthrombin time

TNFTumor necrosis factor

TRALITransfusion-related acute lung injury

TRIMTransfusion-associated immunomodulation

TTPThrombotic thrombocytopenic purpura

vWFvon Willebrand factor.

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Autor: Sonia Labarinas - Delphine Arni - Oliver Karam


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