Fresh Frozen Plasma Transfusion: An Independent Risk Factor for Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants

Chun-Pin Huang; Yi-Li Hung; Wu-Shiun Hsieh; Chung-Min Shen

doi:10.1055/s-0040-1722649

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2022; 39(13): 1426-1432
DOI: 10.1055/s-0040-1722649

Original Article

Fresh Frozen Plasma Transfusion: An Independent Risk Factor for Hemodynamically Significant Patent Ductus Arteriosus in Premature Infants

Authors

Chun-Pin Huang

¹Department of Pediatrics, Cathay General Hospital, Hsinchu Branch, Hsinchu, Taiwan

²Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
Yi-Li Hung

²Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
Wu-Shiun Hsieh

²Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan

³Department of Pediatrics, National Taiwan University Children's Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Chung-Min Shen

²Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan

⁴School of Medical, Fu-Jen Catholic University, Taipei, Taiwan

Abstract

Objective The incidence of patent ductus arteriosus (PDA), a major complication of prematurity, may be reduced by restricting fluid administration. Prophylactic fresh frozen plasma (FFP) transfusion may reduce the incidence of intraventricular hemorrhage in these infants, but risks transfusion-related volume overload. We conducted a retrospective study to investigate whether FFP transfusion is a risk factor for hemodynamically significant PDA (hsPDA) in very low birth weight (BW) premature infants.

Study Design From January 2009 to December 2014, 102 premature infants with gestational age (GA) less than or equal to 30 weeks were admitted to a level III neonatal intensive care unit, and 88 patients were enrolled. Patients were further divided into non-hsPDA (n = 29) and hsPDA groups (n = 59). We retrospectively reviewed demographic characteristics and various perinatal and postnatal variables. Univariate and multivariable analyses were performed to identify risk factors for hsPDA.

Results Compared with non-hsPDA patients, hsPDA patients had lower mean BW and GA, a higher incidence of severe respiratory distress symptoms, perinatal infection, use of surfactant, and need for FFP transfusion. However, multivariable logistic regression analysis showed that only FFP transfusion remained an independent risk factor for hsPDA (adjusted odds ratio = 3.880, 95% confidence interval: 1.214–12.402, p = 0.022) after adjusting for confounding factors.

Conclusion FFP transfusion is a significant risk factor for the subsequent development of hsPDA in our study population. FFP transfusion may complicate the fluid management of premature infants and increase the risk of hsPDA.

Key Points

Hemodynamic significant PDA is an important complication of preterm infant.
FFP transfusion may complicate the fluid management of premature infants.
FFP transfusion is an independent risk factor for hsPDA in very low birth weight premature infants.

Keywords

FFP transfusion - premature infants - hemodynamically significant PDA - intraventricular hemorrhage

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Referenzen

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