FFP Requests: Legend, Lore, and Evidence. Rachel LaCount August 26, 2005. Objectives. Present data from studies on FFP: 1. Resuscitation in burn patients 2. FFP to correct INRs before procedures. Case # 1.
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FFP Requests: Legend, Lore, and Evidence
August 26, 2005
Present data from studies on FFP:
1. Resuscitation in burn patients
2. FFP to correct INRs before procedures
Case # 1
Pt is a 24 yo male s/p flash burn following crash at speedway 8 hours ago. 90% total body surface area with 60% to 70% full-thickness burns.Request for 4 FFP. Pt not bleeding or going to surgery. PT: 16.3, INR: 1.3, PTT: 34.3
Surgery resident: “My attending uses FFP as a colloid fluid for resuscitation”Is this an appropriate use of FFP?What is the data supporting the surgeon’s request?
Edema formation in deep burn:
FFP vs. crystalloid solution in 1st 36o
(12.3 L vs. 22.1 L; p = 0.02)
Data from Mass General physician order entry: Feb to April, 2003
1. Is there data that mild-moderate abnormalities in PT/APTT increase the risk for bleeding during procedures?
2. Does FFP correct these abnormalities and lead to better pt outcomes?
normal & mildly prolonged PT/APTT or plt count
Mean Min Max
PT 12.5 8.8 20.8
PTT 30.0 18.3 150.0
PLT 288.8 17 1,170
Median Min Max
INR 1.8 1.2 3.5
PTT 54 22 100
PLT 95 12 330
Question # 1: Is there data that mild-moderate abnormalities in PT/APTT increase the risk for bleeding during procedures?
Answer: Not that I could find!
Does FFP correct abnormalities in the PT/APTT and lead to better pt outcomes?
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