Coagulopathy and plasma transfusion in critically ill patients

In this thesis, we studied the value of viscoelastic tests (TEG/ROTEM) to assess coagulation status in different critically ill patient populations. In addition, we investigated the effects of prophylactic fresh frozen plasma (FFP) transfusion in critically ill patients with a coagulopathy. Furthermore, the effects of FFP on different tests that evaluate the coagulation system were assessed. Also, the effect of FFP on the occurrence of bleeding and lung injury was studied. In the last part of this thesis, the pathophysiology of transfusion related lung injury (TRALI) was studied in more detail and two potential therapeutic strategies for TRALI were tested in a murine model of antibody mediated TRALI. Lastly, a systematic review and meta-analysis was done to assess the effect of implementing low risk plasma donor strategies on the onset of TRALI.