Use of Fresh Frozen Plasma in Children

This issue of The Journal includes two articles that examine the use of fresh frozen plasma (FFP). At first glance, the authors appear to have differing views as to the benefits and overall utilization strategy of FFP use. Hendrickson et al¹ describe how coagulopathy is independently associated with mortality and morbidity in trauma patients who are injured severely enough to require a transfusion within the first 24 hours of admission. The inference is that early use of FFP in this setting may be an effective way to treat the coagulopathy that can be anticipated. The other article, by Puetz et al,² reviews an administrative database that demonstrates the use of FFP across the United States, then refers the reader to the literature, where FFP has been shown generally to not improve outcomes in controlled trials. The end result is that one study infers that FFP may be useful as an upfront resuscitative tool to correct coagulopathy and improve morbidity and mortality secondary to traumatic injury, whereas the other study infers that FFP is grossly overused in the United States and suggests more limited use or at least an increase in the monitoring of FFP use. What message is the reader to take away?

FFP, Fresh frozen plasma, ICU, Intensive care unit