Fresh frozen plasma: Difference between revisions
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==Indications== | ==Indications== | ||
*Rapid reversal of warfarin anticoagulation (in setting of bleeding or need for invasive procedure) | *Rapid [[warfarin reversal|reversal of warfarin]] anticoagulation (in setting of bleeding or need for invasive procedure) | ||
*Bleeding and multiple coagulation defects (e.g. DIC with significant PT/PTT elevation) | *[[hemorrhage|Bleeding]] and multiple [[coagulopathy|coagulation defects]] (e.g. [[DIC]] with significant PT/PTT elevation) | ||
*Correction of coagulation defects for which no specific factor is available | *Correction of coagulation defects for which no specific factor is available | ||
*Transfusion of more than one blood volume with evidence of active bleeding + coagulopathy | *[[Transfusion]] of more than one blood volume with evidence of active bleeding + coagulopathy | ||
==Adult Dosing== | ==Adult Dosing== | ||
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*10-20 mL/kg (4-6 units in 70kg adult) will increase factors by ~20-30% | *10-20 mL/kg (4-6 units in 70kg adult) will increase factors by ~20-30% | ||
*Transfuse at least 15 mL/kg at a time (4 units in 70-kg adult) | *Transfuse at least 15 mL/kg at a time (4 units in 70-kg adult) | ||
*Must be thawed in 37 degree Celsius water bath for about 45 minutes prior to administration<ref>Westphal RG, Tindle B, Howard PL, Golden EA, Page GA. Rapid thawing of fresh frozen plasma. Am J Clin Pathol. 1982;78(2):220-222. doi:10.1093/ajcp/78.2.220</ref> | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
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==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Hemolytic transfusion reactions | *[[Transfusion reactions]] | ||
*Febrile | **[[Intravascular hemolytic transfusion reaction|Hemolytic transfusion reactions]] | ||
*Transfusion-associated circulatory overload (TACO) | **[[Febrile nonhemolytic transfusion reaction]] | ||
*Transfusion-related acute lung injury (TRALI) | **[[Transfusion-associated circulatory overload]] (TACO) | ||
*Transfusion-associated graft-versus-host disease | **[[Transfusion-related acute lung injury]] (TRALI) | ||
*Anaphylaxis | **[[Transfusion-associated graft-versus-host disease]] | ||
*Sepsis | *[[Anaphylaxis]] | ||
*[[Sepsis]] | |||
===Common=== | ===Common=== | ||
*Headache, paresthesia | *Headache, paresthesia | ||
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**40 mL/kg raises any factor by 100% (each unit is ~200mL) | **40 mL/kg raises any factor by 100% (each unit is ~200mL) | ||
*May cause fluid overload | *May cause fluid overload | ||
*ABO | *ABO compatibility a must but crossmatch before transfusing not | ||
*INR of FFP is ~1.6; therefore transfusing for INR <1.7 is not advised<ref>Holland LL and Brooks JP. Toward rational fresh frozen plasma transfusion: The effect of plasma transfusion on coagulation test results. Am J Clin Pathol. 2006;126(1):133-9. </ref> | *INR of FFP is ~1.6; therefore transfusing for INR <1.7 is not advised<ref>Holland LL and Brooks JP. Toward rational fresh frozen plasma transfusion: The effect of plasma transfusion on coagulation test results. Am J Clin Pathol. 2006;126(1):133-9. </ref> | ||
*Retains active coagulation factors for up to 5 days after being thawed | *Retains active coagulation factors for up to 5 days after being thawed | ||
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==See Also== | ==See Also== | ||
*[[Transfusions]] | *[[Transfusions]] | ||
*[[PCC]] | |||
==References== | ==References== | ||
Latest revision as of 14:07, 25 February 2021
General
- Type: Blood products
- Dosage Forms:
- Common Trade Names:
Indications
- Rapid reversal of warfarin anticoagulation (in setting of bleeding or need for invasive procedure)
- Bleeding and multiple coagulation defects (e.g. DIC with significant PT/PTT elevation)
- Correction of coagulation defects for which no specific factor is available
- Transfusion of more than one blood volume with evidence of active bleeding + coagulopathy
Adult Dosing
- 1 bag = 1 unit = 250 mL
- 10-20 mL/kg (4-6 units in 70kg adult) will increase factors by ~20-30%
- Transfuse at least 15 mL/kg at a time (4 units in 70-kg adult)
- Must be thawed in 37 degree Celsius water bath for about 45 minutes prior to administration[1]
Pediatric Dosing
- Neonates/small children: 10-20 mL/kg will increase factor levels by 15-25%
Special Populations
- Pregnancy Rating: C
- Lactation:
- Renal Dosing:
- Hepatic Dosing:
Contraindications
- Allergy to class/drug
- ABO incompatibility
Adverse Reactions
Serious
Common
- Headache, paresthesia
- Nausea
- Pruritus, urticaria
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Mechanism of Action:
Comments
- Contains all coagulation factors and fibrinogen
- 40 mL/kg raises any factor by 100% (each unit is ~200mL)
- May cause fluid overload
- ABO compatibility a must but crossmatch before transfusing not
- INR of FFP is ~1.6; therefore transfusing for INR <1.7 is not advised[2]
- Retains active coagulation factors for up to 5 days after being thawed
See Also
References
- ↑ Westphal RG, Tindle B, Howard PL, Golden EA, Page GA. Rapid thawing of fresh frozen plasma. Am J Clin Pathol. 1982;78(2):220-222. doi:10.1093/ajcp/78.2.220
- ↑ Holland LL and Brooks JP. Toward rational fresh frozen plasma transfusion: The effect of plasma transfusion on coagulation test results. Am J Clin Pathol. 2006;126(1):133-9.