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Plasma Transfusion and Lung Injury in the Pediatric Intensive Care Unit

Robert A. Niebler, Melissa Christensen and Jennifer McArthur

Introduction: This study investigated if there was an association between Fresh Frozen Plasma (FFP) transfusion and severity of lung injury as measured by the Oxygenation Index (OI) in a Pediatric Intensive Care Unit (PICU) population.

Methods: This was a retrospective cohort study of 178 patients who had data available to calculate the OI (OI = mean airway pressure × FiO2 × 100 / Pa O2 ). 166 patients were transfused with FFP and 12 control patients with an INR > 1.5 who were not transfused with FFP were included. The OI was calculated at time 0 (prior to transfusion or at time of peak INR in controls); 6; 24; and 48 hours later.

Results: Change in the OI was -0.2 ± 4.1, 0.3 ± 4.9, and 0.0 ± 6.8 at 6, 24, and 48 hours respectively in the transfused group and 0.3 ± 0.7, 1.5 ± 5.4, and 3.3 ± 9.5 at 6, 24, and 48 hours respectively in the control group. Multivariate analysis failed to find a significant association between FFP transfusion and a change in the OI.

Conclusion: FFP transfusion was not associated with a change in the severity of lung injury as measured by the OI.