|To study the therapeutic efficacy of Fresh Frozen Plasma in cirrhotic patients with low Prothrombin Index (PTI)|
|R.K. Sharma, Ajay Chhabra, Neeraj Sharma, Sathisha B., Pallavi|
Introduction: Cirrhosis of liver is a growing cause of significant morbidity and mortality of modernization. Cirrhosis patients have a disturbed balance between procoagulant and anti-coagulant factors and a very poor reserve of these factors leads to increased bleeding risk as well as increased thrombotic risk. Aim: To study the therapeutic efficacy of fresh frozen plasma(FFP) transfusion in cirrhotic patients with low prothrombin index and clinical profile of cirrhotic patients before and after FFP transfusion especially with regards to bleeding tendencies. Material and Methods: This prospective observational study included assessment of therapeutic efficacy of fresh frozen plasma in 100 cirrhotic patients with low prothrombin index. We transfused 20ml/kg body weight of FFP for 40%, 10ml/kg body weight of FFP for 40% and 15ml/kg body weight of FFP for 20% of cirrhotic patients with low PTI with bleeding manifestations. Dose of FFP was decided after considering Body weight, level of PTI, Bleeding manifestations & other comorbidities. Prothrombin index and international normalized ratio in cirrhotic patients were recorded before and after transfusion of fresh frozen plasma, prothrombin index test was done by manual method. Clinical efficacy of fresh frozen plasma transfusion on clinical symptoms like hematemesis, melaena, ecchymosis and petechiae in liver cirrhosis patients was recorded and compared before and after transfusion of FFP. Results: 87% were males and 13% were females and Alcohol was the most common etiological agent in cirrhotic patients. Melaena was seen in 72% of patients, hematemesis in 19% of patients, ecchymosis and petechiae in 20 and 21% of patients respectively. We observed that 20ml/kg body weight dose of FFP transfusion was able to not only improve the PTI in a statistically significant manner, but was also able to improve the INR in statistically significant manner(P<0.05), showed greater percentage of improvement in clinical symptoms and lastly was found to be more effective for treating the bleeding manifestation with low PTI level and high INR. Conclusion: Commonly recommended dose of FFP (10-15 ml/kg body weight) in clinical practice infrequently correct the coagulopathy, so higher dose (≥20ml/kg body weight) may be more effective in correction of coagulopathy. Key words: Fresh frozen plasma, liver cirrhosis, prothrombin time, INR.
|Html View | Download PDF | Current Issue|