II. Precautions

  1. Specific factor recombinant or concentrate products are preferred when available
  2. Prothrombin Complex Concentrate (PCC4) is preferred in warfarin Anticoagulation and major bleeding

III. Indications

  1. Warfarin use or INR >1.6 and PCC4 not available AND
    1. Active major bleeding or
    2. Intracranial Hemorrhage
    3. Prevent bleeding prior to emergent major procedure or
    4. Inherited single Clotting Factor deficiency with no available safe factors available
  2. Acute Disseminated Intravascular Coagulation (DIC) with active bleeding (FFP only, not thawed plasma)
  3. Microvascular bleeding during Massive Transfusion (>1 Blood Volume or 5L blood in a 70 kg male)
  4. Replacement fluid for thrombotic microangiopathy (typically in combination with exchange transfusion)
    1. Thrombotic Thrombocytopenic Purpura
    2. Hemolytic Uremic Syndrome
  5. Hereditary Angioedema (if C1 esterase inhibitor is unavailable)
  6. Multifactorial or global Coagulopathy
  7. Massive Hemorrhage Protocol

IV. Preparations

  1. Fresh Frozen Plasma
    1. Contains 200-250 ml per unit
    2. Contains all Coagulation Factors
    3. Does not contain platelets
    4. Increases Fibrinogen 7-10 mg/dl per unit
    5. Dosing: 10-20 ml/kg
  2. Thawed Plasma
    1. May be kept at 33.8 to 42.8 F (1 to 6 C) for up to 5 days
    2. Contains all Coagulation Factors, but lower levels of factor V and factor VIII
    3. Do not use in DIC (use FFP instead)

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Related Studies

Ontology: Fresh frozen plasma (C0016709)

Definition (NCI) The plasma that is separated from the whole blood and frozen quickly after a blood donation in order to be used for blood transfusions.
Definition (MSH) Freshly frozen PLASMA after the removal of PLATELETS.
Concepts Body Substance (T031)
MSH D010949
SnomedCT 126244008, 346447007
LNC LP14557-0
English Fresh Frozen Plasmas, Frozen Plasma, Fresh, Frozen Plasmas, Fresh, Plasma, Fresh Frozen, Plasmas, Fresh Frozen, fresh frozen plasma, FFP, Fresh frozen plasma, human (product), Fresh frozen plasma, human, FFP - Fresh frozen plasma, Fresh frozen plasma (product), Fresh frozen plasma (substance), Fresh frozen plasma, human (substance), Fresh Frozen Plasma, Fresh frozen plasma
Portuguese Plasma Fresco Congelado
Spanish Plasma Fresco Congelado, plasma fresco humano congelado (producto), plasma fresco humano congelado, plasma fresco congelado (producto), plasma fresco congelado, plasma fresco humano congelado (sustancia)
French Plasma congelé
German Frisches gefrorenes Plasma
Italian Plasma congelato fresco
Czech čerstvá mražená plazma
Norwegian Dypfrosset plasma
Dutch Vers diepgevroren plasma

Ontology: Transfusion of plasma (C0278347)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 151009001, 266807001, 151010006, 13569004
English Plasma transfusion, transfusions plasma, transfusions plasma (treatment), plasma transfusion, plasma transfusions, transfusion plasma, Plasma transfusion (procedure), Transfusion of plasma, Transfusion of plasma (procedure)
Dutch plasmatransfusie
French Transfusion de plasma
German Transfusion von Plasma
Italian Trasfusione di plasma
Portuguese Transfusão de plasma
Spanish Transfusión de plasma, transfusión de plasma (procedimiento), transfusión de plasma
Japanese 血漿輸血, ケッショウユケツ
Czech Transfuze plazmy
Hungarian Plazma transzfúzió

Ontology: Transfusion of fresh frozen plasma (C1293883)

Concepts Therapeutic or Preventive Procedure (T061)
SnomedCT 116861002
English fresh frozen plasma transfusion (treatment), fresh frozen plasma transfusion, transfusion of fresh frozen plasma, Fresh frozen plasma administration by intravascular infusion, Transfusion of fresh frozen plasma (procedure), Transfusion of fresh frozen plasma
Spanish administración de plasma fresco congelado mediante infusión intravascular, transfusión de plasma fresco congelado (procedimiento), transfusión de plasma fresco congelado