Fresh frozen plasma

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

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

• Transfusion reactions
  • Hemolytic transfusion reactions
  • Febrile nonhemolytic transfusion reaction
  • Transfusion-associated circulatory overload (TACO)
  • Transfusion-related acute lung injury (TRALI)
  • Transfusion-associated graft-versus-host disease
• Anaphylaxis
• Sepsis

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
• Retains active coagulation factors for up to 5 days after being thawed

See Also

• Transfusions
• PCC