The good use of plasma. A critical analysis of five international guidelines

Background The clinical use of fresh-frozen plasma (FFP) is progressively increasing both nationally and internationally despite the tact that many studies have shown the weaknesses of the indications for its use Guidelines on the good use of plasma have therefore been adopted in various countries The aim of the present study was to analyse some of the existing guidelines on the good use of plasma applying scientifically validated method as a preliminary step in the implementation of Regional guidelines Methods A bibliographic search (1990-2006) was conducted in databases websites, and the archives of scientific societies Relevant articles were recovered in full The selected guidelines were evaluated using the AGREE instrument which assesses the completeness and structural quality of the guidelines and in some aspects, the contents of the recommendations The project, co-ordinated by the Regional Centre for Co-ordination and Compensation (CRCC) and carried out by tour Services of Immunohaematology and Transfusion (SIT) in Umbria was funded by the Region of Umbria and approved by the four health care institutions involved Results The bibliographic search yielded 3067 abstracts of which 239 were considered relevant The analysis of these led to the recovery of 11 guidelines among which five were selected those from the British Committee for Standards in Haematology the Agence Francaisc de Sccunte Sanitaire de Produits de Sunk. the Canadian Members of the Expert Working Group the American Society of Anesthesiologists Task Force on Blood Component Therapy and the National Health and Medical Research Council (NHMRC)/Australasian Society of Blood Transfusion Conclusions None of the guidelines analysed obtained a score higher than 50% in all the domains of the AGREE score There was no evidence of a tendency to Improvement over time in the guidelines analysed Objective evaluation of the guidelines analysed could pi vide the starting point for the subsequent production of similar documents