Background: Plasma transfusions are most commonly used therapeutically for bleeding or prophylactically in non-bleeding patients prior to invasive procedures or surgery. Although plasma transfusions generally seem to decline, plasma usage for indications that lack evidence of efficacy prevail. Summary: There is wide international, interinstitutional, and interindividual variance regarding the compliance with guidelines based on published references, supported by appropriate testing. There is furthermore a profound lack of evidence from randomized controlled trials comparing the effect of plasma transfusion with that of other therapeutic interventions for most indications, including massive bleeding. The expected benefit of a plasma transfusion needs to be balanced carefully against the associated risk of adverse events. In light of the heterogeneous nature of bleeding conditions and their rapid evolvement over time, fibrinogen and factor concentrate therapy, directed at specific phases of coagulation identified by alternative laboratory assays, may offer advantages over conventional blood product ratio-driven resuscitation. However, their outcome benefit has not been demonstrated in well-powered prospective trials. This systematic review will detail the current evidence base for plasma transfusion in adult surgical patients.

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成人外科患者的血浆输注实践：文献系统回顾

背景：在侵入性操作或手术之前，血浆输血最常用于治疗性出血或非出血性患者的预防性出血。尽管血浆输血量似乎普遍下降，但血浆用于缺乏疗效证据的适应症占主导地位。总结：根据已发表的参考文献，并通过适当的测试支持，在遵守指南方面存在广泛的国际、机构间和个体间差异。此外，对于大多数适应症（包括大出血），比较输血与其他治疗干预措施的效果的随机对照试验也缺乏证据。需要仔细权衡血浆输血的预期益处与相关的不良事件风险。鉴于出血状况的异质性及其随时间的快速演变，针对通过替代实验室测定确定的特定凝血阶段的纤维蛋白原和浓缩因子治疗可能比传统的血液制品比率驱动的复苏具有优势。然而，它们的结果益处尚未在有力的前瞻性试验中得到证实。该系统评价将详细介绍成人手术患者输血的当前证据基础。它们的结果益处尚未在有力的前瞻性试验中得到证实。该系统评价将详细介绍成人手术患者输血的当前证据基础。它们的结果益处尚未在有力的前瞻性试验中得到证实。该系统评价将详细介绍成人手术患者输血的当前证据基础。