Plasma Administration

 

Reviewed by Malcolm Battin
July 2008
Clinical Guidelines Newborn Services Home Page
FFP Compatibility Indications Contra-indications Complications
Administration Cautions Ordering

References


Fresh Frozen Plasma (FFP) Neonatal

Fresh frozen plasma for neonates and infants is derived from the harvesting of plasma from regularly attending whole blood donors. The starting donation is then divided into aliquots with a volume of 45mls to 90mls and frozen rapidly within 8 hours of collection to a temperature that will maintain the activity of the labile coagulation factors, as per standard fresh frozen plasma. The specifications, other than the volume, are the same as for standard fresh frozen plasma. Four doses can be obtained from a single donation.

Compatibility

FFP should be ABO compatible

ABO Group

 

Group O

Patient can receive any ABO group

Group A

Patient can receive A or AB FFP

Group B

Patient can receive B or AB FFP

Group AB

Patient can receive only AB FFP

Indications

  1. Single coagulation factor/protein deficiencies.
  2. Liver disease in the presence of bleeding and abnormal coagulation or as a prophylaxis.
  3. Disseminated intravascular coagulopathies (DIC).
  4. Hypovolaemia - not to be used for simple hypovolaemia as expensive and wasteful.

Contra-indications

  1. Plasma exchange procedures ( except for thrombocytopenic purpura or in the presence of coagulopathy.
  2. Treatment of immunodeficiency states.
  3. Not appropriate to use FFP as a plasma expander or for replacement in chronic hypoproteinaemic states.

Complications

  1. Infections with HBV, HIV, bacterial contamination etc. as for red cell transfusion.
  2. Volume overload.
  3. Allergic reactions.
  4. Antibody mediated reactions, e.g. if group A plasma (containing Anti-B) is given to a group B baby, haemolysis may occur. Leucocyte antibodies may be present in donor blood and could cause reactions.
  5. May contribute to rise in blood viscosity.

Administration

  1. The standard therapeutic dose for FFp is 10-15mls/kg body weight.
  2. Once thawed, should be transfused as soon as possible, within 4 hours.
  3. Draw into syringe through a new 170u blood group filter.
  4. As FFP are leucodepleted at source by NZBS, bedside leucodepletion is not necessary.

Cautions

  1. Do not add medication to FFP.
  2. Do not use 5% dextrose solution (may induce haemolysis).
  3. Do not use Lactated Ringer's (contains Ca++, which may induce clot formation in the blood bag and/ or administration set).

Ordering

For individual patients order on Request for Blood Components or Products form through Blood Bank.

For further details, refer to the Transfusion Medicine handbook 2203.

References

  1. NICE (May 2002). Pregnancy - routine anti-D prophylaxis for RhD-negative women.
  2. RhoGam Ultr-Filtered PLUS Rho(D) Immune Globulin (Human) Information Site.
  3. Royal College of Obstetricians and Gynaecologists ( May 2002). Use of Anti_D immunoglobulin for Rh prophylaxis.