Fibrinogen as an indicator for prophylactic fresh frozen plasma transfusion:Significance and initial exploration
Objective:To explore the significance and threshold of fibrinogen(Fib)as an indication for prophy-lactic(fresh frozen plasma,FFP)transfusion.Methods:Normal control plasma was diluted with physiological sa-line,and the changes in prothrombin time(PT)and activated partial thromboplastin time(APTT)with decreasing Fib were observed.A retrospective analysis was conducted on 4 708 coagulation test reports from January 1,2020 to November 30,2022 in patients with bleeding disorders leading to Fib≤1.80 g/L to observe the changes in PT and APTT with decreasing Fib.Fifty patients who received FFP transfusion to improve coagulation function from January 1,2022 to November 30,2022 were retrospectively analyzed to observe the changes in PT,APTT,and Fib before and after transfusion.Results:With the continuous dilution of normal control plasma or increasing bleeding in patients with bleeding disorders,Fib gradually decreased,and PT and APTT prolonged.When Fib≥1.20 g/L,the prolongation of PT and APTT was slow,whereas when Fib＜1.20 g/L,the prolongation of PT and APTT increased significantly.When Fib was below 1.00 g/L in patients with bleeding disorders,clear indica-tions for FFP transfusion were observed in both PT and APTT.Infusing FFP can significantly improve Fib.Con-clusion:For patients with bleeding disorders or those undergoing invasive procedures at a high risk of bleeding,even when PT and APTT are normal,prophylactic FFP transfusion is recommended when Fib＜1.20 g/L to im-prove coagulation function and raise Fib levels,thus reducing the risk of bleeding.
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