Plasma Transfusion
Description Medicine treatment Description Plasma transfusions may be needed in the following scenarios: Coagulopathy due to multiple factor deficiencies, e.g. disseminated intravascular coagulation (DIC), or large volume blood loss. Thrombotic thrombocytopaenic purpura Scoline apnoea Where available, viscoelastic testing (e.g. thromboelastography/TEG) should complement or replace standard coagul
Description
Plasma transfusions may be needed in the following scenarios:
- Coagulopathy due to multiple factor deficiencies, e.g. disseminated intravascular coagulation (DIC), or large volume blood loss.
- Thrombotic thrombocytopaenic purpura
- Scoline apnoea
Where available, viscoelastic testing (e.g. thromboelastography/TEG) should complement or replace standard coagulation testing as this provides a more clinically relevant assessment of functional coagulation.
Consult a specialist for further advice as necessary.
Choice of plasma product
Fresh frozen plasma (FFP) and lyophilized or freeze-dried plasma (FDP) may be treated as clinically interchangeable products with respect to their coagulant effect.
Indications for plasma transfusion
- Prophylaxis: prior to invasive procedures/surgery if International Normalised Ratio (INR) >2.
- Empiric: Large volume blood transfusion (>4 units of packed cells required. See: Massive transfusion protocol).
- Therapeutic: if patient is bleeding and has an INR >2.
Medicine Treatment
Plasma Transfusion
For prophylaxis or therapy:
- Freeze-dried plasma, IV, 15 mL/kg immediately.
- Repeat dose if the patient’s clinical response and/or the coagulation function testing results indicate continued need.
Empiric use in large volume blood transfusion:
- Freeze-dried plasma, IV, 1 unit immediately.
- Should be given for every unit of red blood cells when it is anticipated that >4 units of red blood cells will be required.
Standard Treatment Guidelines and Essential Medicines List for South Africa Adult Hospital _Chapter 23: Adult Critical Care_NEMLC Medicine Recommendations Review Cycle_ 2020_2023