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ILOS
By the end of this lecture, the students will be able to recognize;
What is Fresh frozen plasma and cryoprecipitate.
FRESH FROZEN PLASMA (FFP)
Prepared from whole blood donation and frozen within 6 – 8 hours .
It is stored at – 18o c or colder for up to 12 months.
It contains: 91% water – 7% protein – 2% carbohydrate.
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FRESH FROZEN PLASMA (FFP)
Indications
To treat prolonged PT or PTT
Vitamin K deficiency and liver disease
Dilutional coagulopathy
Protein S, Protein C or Antithronbin deficiency.
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FRESH FROZEN PLASMA (FFP)
Thawing
It should be thawed at temperature 30-37oc in a water bath.
The unit should be wrapped in a plastic bag.
Thawed FFP should be transfused immediately or within 12 hrs or stored between 1-6oc for no more than 12 hours.
It should not be refrozen.
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FRESH FROZEN PLASMA (FFP)
Administration
1. The same ABO as the protein.
2. Given via a filter over 1 – 1.5 hours.
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CRYOPRECIPITATE
Obtained from FFP and concentrated to 10 -20 ml.
It contains F VIII, (80 – 120 Units), v WF, 250 mg fibrinogen, 20 – 30% of factor XIII & fibronectin.
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CRYOPRECIPITATE
Indications
Factor VIII deficiency (Haemophilia A).
Type II VW disease.
Type I VW disease not responding to DDAVP.
Factor XIII deficiency.
Congenital fibrinogen abnormality.
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CRYOPRECIPITATE
Indications
When fibrinogen is ≤ 100 mg.
Control of bleeding in uremic or hepatic patients.
For preparation of fibrin glue: Topical use in orphopedic, ENT, dental, cardiac or neurological procedures.
Reversal of warfarin overdose.
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CRYOPRECIPITATE
Thawing
It should be thawed at 37 0 c immediately before use and the pack should NOT be refrozen.
Fibrinogen dose: 8 – 10 bags supply 2 g fibrinogen.
Infusion
Filter at rate of 1 – 2 ml/min.
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CRYOPRECIPITATE
Cryoprecipirate represents the cryoglobulin fraction of the plasma.
It contains F VIII, VWF, fibrinogen, fibronectin and F XIII.
It is used primarily for the treatment of Haemophilia A patients.
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PLATELET CONCENTRATES
Volume: 50 – 70 ml/unit provide about 5000 platelets. Kept at 20 – 22 0 c in a shaker for a maximum of 5 days.
Should be infused within 4 hours, administered with filter
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PROTHROMBIN COMPLEX
This component contains prothrombin (F II), factor VII, F IX and factor X.
It is lyophylized and virus-inactivated to reduce the risk of transmitting infections.
Indications Haemophilia B (F IX deficiency). Serious coumarin overdosage together with
Vitamin K1 Coagulation defects due to fulminant hepatitis
or liver insufficiency.
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FEIBA AND AUTOPLEX
These are some activated prothrombin complex preparations used for treatment of Haemophilia A patients with inhibitors.
These should be given with caution, as overuse may cause thrombosis and DIC.
Currently, there are factors IX and F VII concentrates for TR of Haemophilia B.
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FIBRIN GLUE
It is formed by the reaction of cryo (fibrinogen) + thrombin as they are applied topically.
Advantage Good hemostasis in different solid organ
bleeding. Prevents post-operative bleeding. Efficient in the presence of coagulation
defect and bacterial contamination.
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