Use of fresh frozen plasma to prevent intraventricular haemorrage in premature neonates

Premature infants are at risk of a range of morbidities which impact significantly on prognosis and outcome,
including intraventricular haemorrhage, sepsis and DIC. Advances in neonatal care have led to improved survival rates of VLBW and ELBW infants, but they remain at risk of morbidity and mortality associated with IVH and other complications of prematurity. Derangement of coagulation has been implicated as a co-factor in the aetiology of IVH (Piotrowski A et al, 2010), along with cardiorespiratory instability, prematurity and low birth weight (Brouwer AJ et al, 2012, Amato M et al 1993, Lemons JA et al, 1996). Standard coagulation tests (prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen) may be measured in extreme premature infants, but these infants have prolonged coagulation values relative to term infants. It is not known whether this is a physiological or a pathological finding in premature infants. It has been postulated that transfusion of fresh frozen plasma in neonates may prevent mortality and morbidity due to haemorrhage. The aim of this systematic review is to evaluate whether administration of frozen plasma improves morbidity or mortality in neonates and to assess the effects of frozen plasma administration on development of intraventricular hemorrhage in preterm infants < 32 weeks gestation.

Award Date
19 September 2014
Award Value
€30,188
Principal Investigator
Dr Elaine Neary
Host Institution
Royal College of Surgeons in Ireland
Scheme
Cochrane Training Fellowships