Normalisation Of The International Normalised Ratio Prior To Interventional Procedure: Is It Necessary?

• Main Author: Mohamad Mahyedin, Mohd Tarmizi
• Format: Thesis
• Language: English
• Published: 2017
• Subjects: RK1-715 Dentistry
• Online Access: http://eprints.usm.my/40604/

Latar belakang: Plasma sejuk segar (fresh frozen plasma; FFP) ialah komponen darah yang sering dipohon oleh doktor sama ada bertujuan untuk transfusi terapeutik atau transfusi profilaktik. Transfusi profilaktik FFP di kalangan pesakit yang mempunyai masalah pembekuan darah (coagulopathy) adalah untuk mengelakkan episod pendarahan ketika prosedur rawatan invasif. Nilai international normalised ratio (INR) melebihi 1.50 sering dijadikan nilai penanda bagi transfusi FFP sebelum prosedur intervensi. Kajian ini berhasrat untuk menilai keberkesanan transfusi FFP dalam menormalkan bacaan INR sebelum prosedur intervensi dijalankan dan menentukan hasil transfusi ini (perbezaan INR, episod pendarahan dan reaksi tindakbalas transfusi). Kaedah: Kajian prospectif keratan rentas dijalankan dengan data daripada 81 pesakit yang menerima transfusi FFP sebelum prosedur intervensi selama tempoh tiga bulan (Disember 2016 hingga Febuari 2017). Kajian ini telah dijalankan di Hospital Kuala Lumpur dan Pusat Darah Negara. Subjek kajian ini dipilih secara persampelan khusus di mana setiap pesakit yang merekodkan bacaan INR melebihi 1.50 dipilih. Data diperoleh daripada rekod perubatan pesakit dan diisi dalam proforma kajian. Kesemua data demografik dan klinikal berkaitan dengan keberkesanan transfusi FFP dicatatkan dan kemudiannya dianalisa. Background: The fresh frozen plasma (FFP) is frequently prescribed by the clinicians either for therapeutic or prophylactic purpose. Prophylactic FFP transfusion in coagulopathic patient is given to prevent any bleeding complications during invasive procedures. The international normalised ratio (INR) value of 1.50 and above is frequently reported to be a transfusion trigger for FFP prior to interventional procedure. This study aims to evaluate the efficacy of FFP transfusion in normalising the INR prior to interventional procedures. On top of that, it is also to determine the post-transfusion outcomes (INR difference, bleeding episodes and adverse transfusion reactions). Methods: A prospective cross-sectional study involved 81 patients who received prophylactic FFP transfusion prior to interventional procedures over a period of three months (December 2016 until February 2017). The study was conducted at both Hospital Kuala Lumpur and Pusat Darah Negara. Study subjects with abnormal coagulation laboratory value (pretransfusion INR above 1.50) were selected by purposive (nonprobability) sampling. Data retrieved from patient’s medical record and were filled in the research proforma. All demographic and clinical data in regards to the outcome of FFP transfusion were captured