Here’s
an interesting article… when doing plasma exchanges, there’s a lot to
exchange, and a lot of different things to exchange.
“Albumin replacement also removes the
clotting proteins that plasma would otherwise supply. Each albumin-only
exchange removes about 60% of plasma fibrinogen, and hepatic synthesis restores
only about 60% of that loss over 48 hours. Two daily albumin exchanges in a row
can easily drive fibrinogen below 100 mg/dL, the level where bleeding risk
becomes clinically relevant“.
Seriously worth bearing
in mind… back in the day we used to issue one unit of FFP after ever four units
of blood transfused for this very reason.
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