Evaluation of the indications for the use of human albümin and fresh frozen plasma in our hospital

Objective: Human albumin (HA) and fresh frozen plasma (FFP) are frequently used in clinics. There are also uses that do not comply with the guidelines, and these uses increase the cost and potential for side effects. In this study, we investigated the compliance of the indications of HA and TDPs used in our hospital in 2018 and 2022 with the current guidelines. Materials and Methods: The study was conducted retrospectively and single center. All patients aged 18 and over who received HA and FFP infusion at Karadeniz Technical University Farabi Hospital between 2018 and 2022 were included in the study. Demographic data and laboratory parameters of the patients were recorded. Epicrisis and consultation notes were scanned to determine the indication for infusion. Human albumin indications were evaluated based on the 'UW Health Albumin - Adult - Inpatient Clinical Practice Guideline'. Fresh frozen plasma indications were evaluated based on the Patient Blood Management Guides prepared by the Blood and Blood Products Department of the General Directorate of Health Services under the Ministry of Health of the Republic of Turkey within the scope of the Technical Assistance Project for the Development of the Blood Transfusion Management System in Turkey and revised in 2023. Results: One thousand one hundred and twenty five patients who were given HA in 2018 and 661 patients who were given HA in 2022 at Karadeniz Technical University Farabi Hospital were analyzed retrospectively. A total of 19486 boxes of HA solution were used in 1786 patients. The departmants that used HA the most were intensive care (6367 boxes), oncology (1845 boxes), gastroenterology (1727 boxes) and general surgery (1561 boxes). The top indications for which HA was administered were treatment of hypoalbuminemia without edema and hypervolemia, in the indications of hypoalbuminemia in the diuretic-resistant hypervolemic patient and hypoalbuminemia in the patient with edema. None of the patients experienced any complications HA infusion related. Inappropriate infusion of HA was determined in 514 (45.7%) of the patients in 2018 and in 242 (36.6%) in 2022. The difference between the two years was statistically significant (p<0.001). One thousand six hundred and fifty-two patients who were given FFP at Karadeniz Technical University Farabi Hospital in 2018 and 1496 patients who were given FFP in 2022 were analyzed retrospectively. A total of 16255 units of TDP were used in 3148 patients. The departmants that used FFP the most were general surgery (3540 units), intensive care (3339 units) and hematology services (2436 units). The top indications for which FFP was administered were frequently used for volume replacement, massive transfusion and non-massive transfusion indications. Inappropriate transfusion of FFP was determined 1093 (66.2%) of the patients in 2018 and 1014 (67.8%) in 2022. The difference between the two years was not statistically significant (p:0.182). Side effects were observed in 3 (0.2%) of the patients in 2018 and 2 (0.1%) of the patients in 2022. Urticaria developed in four patients. Adrenaline was administered to one patient because anaphylaxis developed. No death related to side effects was detected. Conclusion: As a result of the study, it was determined that awareness about the use of HA increased over the years, but there was no significant change in the use of FFP. In the cause of inappropriate use continues, in our center and in our country it is necessary to create guidelines for the use of HA and FFP and to increase the level of awareness. Keywords: Human albumin, fresh frozen plasma, transfusion, indication