Mohamad Mahyedin, Mohd Tarmizi
(2017)
Normalisation Of The International Normalised
Ratio Prior To Interventional Procedure: Is It
Necessary?
Masters thesis, Universiti Sains Malaysia.
Abstract
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
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