• Rationale and Comments

    Plasma transfusion to a patient with an international normalized ratio of less than 1.6 has minimal effect, and transfusion for international normalized ratio values between 1.6 and 2 should be carefully considered. Since a mildly elevated international normalized ratio is usually not associated with spontaneous hemorrhage and doesn’t increase the risk of bleeding during routine invasive procedures, excessive transfusion of plasma is unnecessary and increases the risk of transfusion-associated circulatory overload, which is a leading cause of transfusion associated morbidity and mortality. Judicious use of vitamin K and/or prothrombin complex concentrate following evidence-based clinical practice guidelines should also be considered to avoid unnecessary transfusion.

    Sponsoring Organizations

    • American Society for Clinical Pathology


    • Expert consensus


    • Hematologic


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