Résumé
Alors que les transfusions sanguines sont utilisées depuis le xix e siècle, le plasma n’est disponible que depuis 1941. Pendant la Seconde Guerre mondiale puis la guerre de Corée, le plasma était principalement utilisé comme remplissage vasculaire. L’indication aux transfusions de plasma a depuis été progressivement modifiée, pour devenir principalement un moyen de corriger des déficits en facteurs de la coagulation ou de prévenir des saignements. Actuellement, c’est un traitement fréquemment utilisé dans les unités de réanimation adultes et pédiatriques.
De nombreuses études observationnelles ont cependant montré que les transfusions de plasma ne corrigent pas les troubles modérés de la coagulation. De plus, des études épidémiologiques récentes ont également décrit que ces transfusions sont associées à une augmentation de la morbidité et mortalité chez les patients sévèrement malades. C’est pourquoi le plasma, comme n’importe quel autre traitement, ne devrait être utilisé que si les bénéfices dépassent les risques. La plupart des experts, basés sur des données observationnelles, conseillent donc de limiter son utilisation aux patients avec un saignement massif, ou en présence d’un saignement actif associé à un trouble de la coagulation documenté et d’éviter l’utilisation du plasma en l’absence de saignement quels que soient les résultats de l’hémostase.
Dans cette revue, nous allons revoir l’évidence actuellement disponible sur les transfusions de plasma et discuter de ses indications.
Abstract
Whereas red blood cell transfusions have been used since the nineteenth 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 correcting coagulation factors deficiencies or to preventing 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 non-bleeding patients whatever their coagulation tests.
In this paper, we will review current evidence on plasma transfusions and discuss its indications.
Article PDF
References
O’Shaughnessy DF, Atterbury C, Bolton Maggs P, et al (2004) Guidelines for the use of fresh-frozen plasma, cryoprecipitate and cryosupernatant. Br J Haematol 126:11–28
Schmidt PJ (2012) The plasma wars: a history. Transfusion 52 Suppl 1:2S–4S
Stanworth SJ, Hyde CJ, Murphy MF (2007) Evidence for indications of fresh frozen plasma. Transfus Clin Biol 14:551–6
Stanworth SJ (2007) The evidence-based use of FFP and cryoprecipitate for abnormalities of coagulation tests and clinical coagulopathy. Hematology Am Soc Hematol Educ Program 2007:179–86
Ewalenko P, Deloof T, Peeters J (1986) Composition of fresh frozen plasma. Crit Care Med 14:145–6
Alhumaidan H, Cheves T, Holme S, et al (2010) Stability of coagulation factors in plasma prepared after a 24-hour room temperature hold. Transfusion 50:1934–42
Cardigan R, van der Meer PF, Pergande C, et al (2011) Coagulation factor content of plasma produced from whole blood stored for 24 hours at ambient temperature: results from an international multicenter BEST Collaborative study. Transfusion 51:50S–57S
Hellstern P, Solheim BG (2011) The Use of Solvent/Detergent Treatment in Pathogen Reduction of Plasma. Transfus Med Hemother 38:65–70
Benjamin RJ, McLaughlin LS (2012) Plasma components: properties, differences, and uses. Transfusion 52(Suppl 1):9S–19S
Scott E, Puca K, Heraly J, et al (2009) Evaluation and comparison of coagulation factor activity in fresh-frozen plasma and 24-hour plasma at thaw and after 120 hours of 1 to 6°C storage. Transfusion 49:1584–91
Borgman MA, Maegele M, Wade CE (2011) Pediatric Trauma BIG Score: Predicting Mortality in Children After Military and Civilian Trauma. Pediatrics 127:e892–7
Zink K, Sambasivan C, Holcomb J (2009) A high ratio of plasma and platelets to packed red blood cells in the first 6 hours of massive transfusion improves outcomes in a large multicenter study. Am J Surg 197:565–70
Holland LL, Brooks JP (2006) Towards rational fresh frozen plasma transfusion: The effect of plasma transfusion on coagulation test results. Am J Clin Pathol 126:133–9
Abdel-Wahab OI, Healy B, Dzik WH (2006) Effect of fresh-frozen plasma transfusion on prothrombin time and bleeding in patients with mild coagulation abnormalities. Transfusion 46:1279–85
Vamvakas EC, Blajchman MA (2007) Transfusion-related immunomodulation (TRIM): an update. Blood Rev 21:327–48
Dzik WH (2002) Leukoreduction of blood components. Curr Opin Hematol 9:521–6
Schneider SO, Rensing H, Graber S (2009) Impact of platelets and fresh frozen plasma in contrast to red cell concentrate on unstimulated and stimulated cytokine release in an in vitro model of transfusion. Scand J Immunol, 70:101–5
Heiden M, Seitz R (2002) Quality of therapeutic plasmarequirements for marketing authorization. Thromb Res 107 Suppl: S47–51
Weisbach V, Wanke C, Zingsem, et al (1999) Cytokine generation in whole blood, leukocyte-depleted and temporarily warmed red blood cell concentrates. Vox Sang 76:100–6
Agence française de sécurité sanitaire des produits de santé (2010) Rapport Annuel Hémovigilance 2010. 2011:68
Stramer SL (2007) Current risks of transfusion-transmitted agents: a review. Arch Pathol Lab Med 131:702–7
Khan H, Belsher J, Yilmaz M, et al (2007) Fresh-frozen plasma and platelet transfusions are associated with development of acute lung injury in critically ill medical patients. Chest 131:1308–14
Holness L, Knippen MA, Simmons L, et al (2004) Fatalities caused by TRALI. Transfus Med Rev 18:184–8
Sadis C, Dubois MJ, Mélot C, et al (2007) Are multiple blood transfusions really a cause of acute respiratory distress syndrome? Eur J Anaesthesiol 24:355–61
Stainsby D, Jones H, Wells AW, et al (2008) on behalf of the SHOT Steering Group: Adverse outcomes of blood transfusion in children: analysis of UK reports to the serious hazards of transfusion scheme 1996–2005. Br J Haematol 141:73–9
Sarani B, Dunkman WJ, Dean L, et al (2008) Transfusion of fresh frozen plasma in critically ill surgical patients is associated with an increased risk of infection. Crit Care Med 36:1114–8
Church G, Matthay MA, Liu K, et al (2009) Blood product transfusions and clinical outcomes in pediatric patients with acute lung injury. Pediatr Crit Care Med 10:297–302
Karam O, Lacroix J, Robitaille N, et al (2013) Association between plasma transfusions and clinical outcome in critically ill children: a prospective observational study. Vox Sang 104:342–9
Narick C, Triulzi DJ, Yazer MH (2012) Transfusion-associated circulatory overload after plasma transfusion. Transfusion 52:160–5
Liumbruno G, Bennardello F, Lattanzio A, et al (2009) Italian Society of Transfusion Medicine and Immunohaematology (SIMTI) Work Group: Recommendations for the transfusion of plasma and platelets. Blood Transfus 7:132–50
Report of the US Department of Health and Human Services: The 2009 National Blood Collection and Utilization Survey Report. Washington DC: 2011.
Puetz J, Witmer C, Huang YS, et al (2012): Widespread Use of Fresh Frozen Plasma in US Children’s Hospitals Despite Limited Evidence Demonstrating a Beneficial Effect. J Pediatr 160:210–5
Dzik W, Rao A (2004) Why do physicians request fresh frozen plasma? Transfusion 44:1393–4
Lauzier F, Cook D, Griffith L, et al (2007) Fresh frozen plasma transfusion in critically ill patients. Crit Care Med 35:1655–9
Arnold DM, Lauzier F, Whittingham H, et al (2011) A multifaceted strategy to reduce inappropriate use of frozen plasma transfusions in the intensive care unit. J Crit Care 26:636.e7–636.e13
Shariff M, Maqbool S, Butt TK, et al (2007) Justifying the clinical use of fresh frozen plasma — an audit. J Coll Physicians Surg Pak 17:207–10
Karam O, Tucci M, Lacroix J, et al (2014) International survey on plasma transfusion. Transfusion 54:1125–32
Damiani G, Pinnarelli L, Sommella L, et al (2010) Appropriateness of fresh-frozen plasma usage in hospital settings: a metaanalysis of the impact of organizational interventions. Transfusion 50:139–44
Cooper ES, Bracey AW, Horvath AE, et al (1994) Practice parameter for the use of fresh-frozen plasma, cryoprecipitate, and platelets. JAMA 271:777–81
Expert Working Group (1997) Guidelines for red blood cell and plasma transfusion for adults and children. CMAJ 156:S1–S24
Tripodi A, Chantarangkul V, Primignani M, et al (2007) The international normalized ratio calibrated for cirrhosis (INR (liver)) normalizes prothrombin time results for model for endstage liver disease calculation. Hepatology 46:520–7
Kamath PS, Wiesner RH, Malinchoc M, et al (2001) A model to predict survival in patients with end-stage liver disease. Hepatology 33:464–70
Bolliger D, Seeberger MD, Tanaka KA (2012) Principles and practice of thromboelastography in clinical coagulation management and transfusion practice. Transfus Med Rev 26:1–13
Afshari A, Wikkelso A, Brok J, et al (2011) Thrombelastography (TEG) or thromboelastometry (ROTEM) to monitor haemotherapy versus usual care in patients with massive transfusion. Cochrane Database Syst Rev 3:CD007871
Stravitz RT, Lisman T, Luketic VA (2012) Minimal effects of acute liver injury/acute liver failure on hemostasis as assessed by thromboelastography. J Hepatol 56:129–36
Agarwal B, Wright G, Gatt A (2012) Evaluation of coagulation abnormalities in acute liver failure. J Hepatol 57:780–6
Pekelharing J, Furck A, Banya W (2013) Comparison between thromboelastography and conventional coagulation tests after cardiopulmonary bypass surgery in the paediatric intensive care unit. Int J Lab Hematol [Epub ahead of print]
Segal JB, Dzik WH (2005) Paucity of studies to support that abnormal coagulation test results predict bleeding in the setting of invasive procedures: an evidence-based review. Transfusion 45:1413–25
Dzik WH (2004) Predicting hemorrhage using preoperative coagulation screening assays. Current hematology reports 3:324–30
Finfer S, Bellomo R, Boyce N (2004) A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med 350:2247–56
Yang L, Stanworth S, Hopewell S (2012) Is fresh-frozen plasma clinically effective? An update of a systematic review of randomized controlled trials (CME). Transfusion 52:1673–86
Cotton BA, Au BK, Nunez TC, et al (2009) Predefined massive transfusion protocols are associated with a reduction in organ failure and postinjury complications. J Trauma 66:41–8
Nacoti M, Cazzaniga S, Lorusso F, et al (2012) The impact of perioperative transfusion of blood products on survival after pediatric liver transplantation. Pediatr Transplant 16:357–66
Karam O, Tucci M, Combescure C, et al (2013) Plasma transfusions strategies for critically ill patients. Cochrane Data Base Syst Rev 12:CD010654
Stramer SL (2007) Current risks of transfusion-transmitted agents: a review. Arch Pathol Lab Med 131:702–7
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Labarinas, S., Arni, D. & Karam, O. Transfusions de plasma en réanimation pédiatrique. Réanimation 23, 455–462 (2014). https://doi.org/10.1007/s13546-014-0900-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13546-014-0900-2