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Plasma Transfusion Guidelines

Posted by sammy on February 5, 2013 at 4:30 PM

Plasma

Major Products Available:

 

Fresh Frozen Plasma (FFP)

 

Plasma Frozen Within 24 hours After Phlebotomy

(FP24)

 

FFP Thawed

 

Plasma, Cryoprecipitate Reduced

 

UCG 2010 164

 

 

 

7. Guidelines for appropriate use of blood

Description/Contents:

 

All plasma products are prepared by separation

from whole blood by centrifugation. The volume of

plasma varies and appears on the label. Fresh

Frozen Plasma contains all soluble clotting factors

and contains the plasma from one unit of whole

blood, approximately 250 ml, separated and frozen

within 8 hours of collection. FFP Thawed should be

transfused within 24 hours. Plasma Frozen Within

24 hours After Phlebotomy has somewhat reduced

levels of Factor VIII (65-80%). Thawed Plasma is a

unit of FFP or FP24 thawed at 30-37 oC and

maintained at 1-6 oC for up to 5 days. Levels of

Factors V and VIII in Thawed Plasma are reduced

and Thawed Plasma should not be used to treat

patients with deficiencies of these factors. Plasma,

Cryoprecipitate Reduced is prepared by thawing FFP

at 4 oC and removing the Cryoprecipitate, which

yields plasma that is depleted in Factor VIII, von

Willebrand factor (vWF), fibrinogen, Factor XIII,

and fibronectin. Other proteins such as albumin,

Factors II, V, VII, IX, X, and XI are unaffected.

 

Indications*:

 

Bleeding, preoperative, or massively transfused

patients with a deficiency of multiple

coagulation factors.

Patients with bleeding and/or urgent invasive

procedures on warfarin therapy. Vitamin K will

reverse the warfarin defect in about 12 hours.

Thrombotic thrombocytopenic purpura and

related syndromes.

Congenital or acquired coagulation factor

deficiency when no concentrate is available.

UCG 2010

165

 

 

 

7. Guidelines for appropriate use of blood

Specific plasma protein deficiencies. Examples

include Anti-thrombin III deficiency and C-1

esterase deficiency (hereditary angioedema).

Specific treatment protocols for these rare

conditions should be referenced.

Disseminated Intra-vascular coagulation (DIC)

such as in disseminated septaecimia following

surgery, abruptio placenta and post abortion

sepsis.

* Not all plasma products are suitable for all the

above indications. The choice of plasma

product should be based on the underlying

deficiency and the contents of the available

plasma products (see description/content).

Plasma product transfusion for coagulopathies is

not indicated unless the Prothrombin Time (PT) or

Partial Thrombin Time (aPTT) is >1.5 times the

midpoint of the normal values.

 

Do not transfuse plasma products for volume

expansion, for prophylaxis following

cardiopulmonary bypass, or as a nutritional

supplement. Dosage and Administration:

 

Plasma product transfusions should be ABO

compatible. Crossmatching and Rh compatibility are

not required for plasma product transfusions. The

usual starting dose is 10-15 mL/kg (i.e. 3-4 units

for a 70-kg patient). An assessment of the effect of

the product on the bleeding problem should be

made before continuing therapy.

 

Alternative Therapy:

 

For volume expansion, saline, other electrolyte

solutions, albumin, or synthetic colloids are safer,

cheaper and more effective. When appropriate, a

specific coagulation factor concentrate should be

used for treatment. Treatment with vitamin K can

 

UCG 2010

166

 

 

 

7. Guidelines for appropriate use of blood

avoid the need for plasma transfusion in patients

with vitamin K deficiency or on warfarin.

Categories: None

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