van Haeren, Maite M TMaite M Tvan HaerenRaasveld, Senta JorindeSenta JorindeRaasveldde Bruin, SanneSannede BruinReuland, Merijn CMerijn CReulandvan den Oord, ClaudiaClaudiavan den OordSchenk, JimmyJimmySchenkAubron, CécileCécileAubronBakker, JanJanBakkerCecconi, MaurizioMaurizioCecconiFeldheiser, AarneAarneFeldheiserde Grooth, Harm-JanHarm-Jande GroothMeier, JensJensMeierScheeren, Thomas W LThomas W LScheerenMcQuilten, ZoeZoeMcQuiltenFlint, AndrewAndrewFlintHamid, TarikulTarikulHamidPiagnerelli, MichaëlMichaëlPiagnerelliMahečić, Tina TomićTina TomićMahečićBenes, JanJanBenesRussell, LeneLeneRussellAguirre-Bermeo, HernanHernanAguirre-BermeoTriantafyllopoulou, KonstantinaKonstantinaTriantafyllopoulouChantziara, VasilikiVasilikiChantziaraGurjar, MohanMohanGurjarMyatra, Sheila NainanSheila NainanMyatraPota, VincenzoVincenzoPotaElhadi, MuhammedMuhammedElhadiGawda, RyszardRyszardGawdaMourisco, MafaldaMafaldaMouriscoLance, MarcusMarcusLanceNeskovic, VojislavaVojislavaNeskovicPodbregar, MatejMatejPodbregarLlau, Juan VJuan VLlauQuintana-Diaz, ManualManualQuintana-DiazCronhjort, MariaMariaCronhjortPfortmueller, Carmen A.Carmen A.PfortmuellerYapici, NihanNihanYapiciNielsen, Nathan DNathan DNielsenShah, AkshayAkshayShahVlaar, Alexander P JAlexander P JVlaarMüller, Marcella C AMarcella C AMüller2025-01-152025-01-152025-01https://boris-portal.unibe.ch/handle/20.500.12422/194675Background Current guidelines discourage prophylactic plasma use in non-bleeding patients. This study assesses global plasma transfusion practices in the intensive care unit (ICU) and their alignment with current guidelines.Study Design And Methods This was a sub-study of an international, prospective, observational cohort. Primary outcomes were in-ICU occurrence rate of plasma transfusion, proportion of plasma events of total blood products events, and number of plasma units per event. Secondary outcomes included transfusion indications, INR/PT, and proportion of events for non-bleeding indications.Results Of 3643 patients included, 356 patients (10%) experienced 547 plasma transfusion events, accounting for 18% of total transfusion events. A median of 2 (IQR 1, 2) units was given per event excluding massive transfusion protocol (MTP) and 3 (IQR 2, 6) when MTP was activated. MTP accounted for 39 (7%) of events. Indications of non-MTP events included active bleeding (54%), prophylactic (25%), and pre-procedure (12%). Target INR/PT was stated for 43% of transfusion events; pre-transfusion INR/PT or visco-elastic hemostatic assays (VHA) were reported for 73%. Thirty-seven percent of events were administered for non-bleeding indications, 54% with a pre-transfusion INR < 3.0 and 30% with an INR < 1.5.Discussion Plasma transfusions occurred in 10% of ICU patients. Over a third were given for non-bleeding indications and might have been avoidable. Target INR/PT was not stated in more than half of transfusions, and pre-transfusion INR/PT or VHA was not reported for 27%. Further research and education is needed to optimize guideline implementation and to identify appropriate indications for plasma transfusion.enICUcritically illintensive care unitplasmatransfusiontransfusion practices600 - Technology::610 - Medicine & healtharticle10.48620/846573969677910.1111/trf.18071