II. Precautions
- Specific factor recombinant or concentrate products are preferred when available
- Prothrombin Complex Concentrate (PCC4) is preferred in warfarin Anticoagulation and major bleeding
III. Indications
-
Warfarin use or INR >1.6 and PCC4 not available AND
- Active major bleeding or
- Intracranial Hemorrhage
- Prevent bleeding prior to emergent major procedure or
- Inherited single Clotting Factor deficiency with no available safe factors available
- Acute Disseminated Intravascular Coagulation (DIC) with active bleeding (FFP only, not thawed plasma)
- Microvascular bleeding during Massive Transfusion (>1 Blood Volume or 5L blood in a 70 kg male)
- Replacement fluid for Thrombotic Microangiopathy (typically in combination with exchange transfusion)
- Hereditary Angioedema (if C1 esterase inhibitor is unavailable)
- Multifactorial or global Coagulopathy
- Massive Hemorrhage Protocol
IV. Preparations
- Fresh Frozen Plasma
- Contains 200-250 ml per unit
- Contains all Coagulation Factors
- Does not contain Platelets
- Increases Fibrinogen 7-10 mg/dl per unit
- Dosing: 10-20 ml/kg
- Thawed Plasma
- May be kept at 33.8 to 42.8 F (1 to 6 C) for up to 5 days
- Contains all Coagulation Factors, but lower levels of Factor V and Factor VIII
- Do not use in DIC (use FFP instead)