Evaluation of Fresh Frozen Plasma Usage in Neonates

OBJECTIVE: Fresh frozen plasma (FFP) is widely used in neonatal intensive care units (NICUs), though guidelines limit use. STUDY DESIGN: Neonates were retrospectively analyzed. Demographic and clinical features, transfusions, and guideline adherence were evaluated. Subgroup analyses included preterm/term, bleeding, number of transfusions, and survival. RESULTS: Of 1538 neonates, 143 (9.3%) received 1279 units of FFP, averaging 8.9 units per patient. Forty-three (30.1%) received 1 unit, and 100 (69.9%) received multiple units. Bleeding occurred in 74 (51.7%), and 58 (40.6%) died. Coagulation parameters were assessed in 63.6% before transfusion. Only 20.3% of transfusions met the guidelines. No differences were found between preterm/term neonates regarding usage, appropriateness, or mortality. Multiple transfusions were linked to higher mortality (P=0.017) and increased multisite bleeding risk (OR=2.58). CONCLUSIONS: Fresh frozen plasma transfusions were frequently used in our neonatal intensive care unit, often discordant with national guidelines, reflecting variability in transfusion practice.