Don’t transfuse plasma to correct a laboratory value; treat the clinical status of the patient

Plasma transfusion to a patient with an INR of <1.6 has minimal effect, and transfusion for INR values between 1.6 and 2 should be carefully considered. Since a mildly elevated INR 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 (TACO), 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.