Clinico-laboratory outcomes of plasma transfusion in the Egyptian’s pediatric intensive care units—a prospective observational study

Abstract

Despite the paucity of data supporting their indications, plasma transfusions (PT) are regularly administered for critically ill patients (CIP) in pediatric intensive care units (PICU). The aim of this study was to identify the actual indications for PT in the Egyptian’s PICUs and determine to what extent it affects the clinic-laboratory outcomes for CIP. A prospective observational study was conducted for 6 months on 180 CIP in PICUs of Cairo University Hospital who received plasma for at least one time during their length of stay (LOS). Full history, examination, and investigations were obtained from the medical records. Plasma was transfused in 64.4% of the studied population to support moderate and severe critical illness identified by multiple organ dysfunction score (MODS). Meanwhile, subjective-based physician conceptions accounted for 12.8% of all indications for plasma transfusion. PT in CIP was associated with a significant reduction in platelet count, prothrombin time, partial thromboplastin time, and international normalized ratio with p-value < 0.001, while there was a significant increase in hemoglobin level with p-value < 0.001. A statistically positive correlation exists between the time interval between admission and 1st PT and LOS with a p-value < 0.001 being shorter with earlier transfusion. Of the 180 patients enrolled in this study, seventy patients (38.9%) died, while 110 patients (61.1%) survived. A statistically significant increase in mechanical ventilation (MV) (p = 0.004), total number of PT (p < 0.001), and MODS score (p < 0.001) were recorded in dead CIP compared with survivors. Moderate and severe critical illness identified by MODS was the most frequent cause for PT in the Egyptian’s PICUs. Early, precise, and objectively based PT has a strong role in improving the outcomes in CIP.