Use of fresh frozen plasma
A unit of fresh frozen plasma contains all coagulation factors. Use it for patients with a coagulopathy who are bleeding or at risk of bleeding, and where a specific therapy or factor concentrate is not appropriate or unavailable.
You may give fresh frozen plasma to replace labile plasma coagulation factors during massive transfusion, cardiac bypass, liver disease or acute disseminated intravascular coagulation in the presence of bleeding and abnormal coagulation.
It is appropriate to use this in cases of warfarin overdose with life threatening bleeding in addition to Prothrombin Complex Concentrates (vitamin K–dependent factor concentrates, eg Prothrombinex-VF).
Fresh frozen plasma is an accepted treatment for patients with thrombotic thrombocytopenic purpura often in conjunction with plasma exchange.
Do not use fresh frozen plasma in the following circumstances:
when you can correct coagulopathy effectively with specific therapy, such as vitamin K, cryoprecipitate, factor VIII or other specific factor concentrates
in plasma exchange procedures except for treatment in thrombotic thrombocytopenic purpura
treatment of immunodeficiency states
- when you can safely and adequately replace blood volumes with volume expanders, such as 0.9% Sodium Chloride Injection, Hartmann’s Solution, or appropriate colloids.
The volume transfused depends on the clinical situation and patient size, and should be guided by laboratory assays of coagulation function. The general guide is 10–15 mL/kg per dose.
- National Health and Medical Research Council & Australasian Society of Blood Transfusion. Clinical Practice Guidelines on the Use of Blood Components. Commonwealth of Australia, October 2002.