26 October 2024 (Saturday) - FFP & Cryoprecipitate

Following on from the last BTLP-TACT exercise, I had a little look on Google to remind myself…

 

Fresh frozen plasma (FFP) is recommended for a variety of conditions, including:

 

·        Bleeding

FFP is used to prevent or stop bleeding, or to replace coagulation factors in patients with abnormal coagulation tests. It can be used for patients with:

·        Disseminated intravascular coagulation (DIC)

·        Bleeding associated with acute blood loss

·        Bleeding in patients with decompensated liver disease

·        Warfarin overdose with life-threatening bleeding

·         

·        Surgery

FFP is used for patients with abnormal coagulation tests who are undergoing a planned surgery or invasive procedure.

 

·        Plasma exchange

FFP is used for plasma exchange in patients with thrombotic thrombocytopenic purpura (TTP) or hyperviscosity syndrome.

 

·        Factor deficiency

FFP is used to replace coagulation factors in patients with congenital or acquired factor deficiency.

 

·        Trauma

FFP is used for trauma patients requiring massive transfusion.

 

Fresh frozen plasma (FFP) is NOT recommended in the following situations: 

 

·        When there are more effective treatments

FFP is not recommended when there are more effective treatments for the condition, such as vitamin K, cryoprecipitate, or factor VIII. 

 

·        When blood volume can be replaced

FFP should not be used as a volume expander unless there is active bleeding and coagulation deficiencies.

 

·        To reverse anticoagulation

FFP should not be used to reverse anticoagulation caused by heparin, direct thrombin inhibitors, or direct factor Xa inhibitors.

 

·        For disseminated intravascular coagulation

FFP is not recommended for disseminated intravascular coagulation without bleeding.

 

·        For vitamin K deficiency

FFP should not be used to reverse vitamin K deficiency for neonates or patients in intensive care units. 

 

·        For patients with normal clotting

FFP should not be used for patients who are bleeding due to a surgical cause and who have normal clotting. 

 

·        As a circulating volume replacement

FFP should never be used as circulating volume replacement. 

 

 

Cryoprecipitate is recommended for patients who have low levels of clotting proteins, especially fibrinogen, or who are bleeding or have a risk of bleeding:

 

·        Bleeding

Cryoprecipitate can be used to prevent or control bleeding in patients whose blood doesn't clot properly.

 

·        Invasive procedures

Cryoprecipitate can be used before an invasive procedure in patients with significant hypofibrinogenemia.

 

·        Massive transfusions

Cryoprecipitate is often used when a patient needs a large number of blood components at once. 

 

·        Fibrinogen deficiency

Cryoprecipitate can be used to treat acquired fibrinogen deficiency or dysfibrinogenaemia.

 

·        Disseminated intravascular coagulation (DIC)

Cryoprecipitate can be used to treat DIC.

 

 

Cryoprecipitate is NOT recommended for the following conditions: 

 

·        Hemophilia A

Cryoprecipitate should not be used to treat Hemophilia A unless other factor VIII preparations are not available.

 

·        Von Willebrand disease

Cryoprecipitate should not be used to treat von Willebrand disease unless the patient does not respond to DDAVP. 

 

·        Factor XIII deficiency

Cryoprecipitate is not usually given for Factor XIII deficiency because virus-inactivated concentrates of this protein are available.

 

·        Congenital afibrinogenemia or dysfibrinogenemia

Cryoprecipitate should not be used to treat these conditions.

 

·        Factor deficiencies

Cryoprecipitate should not be used to treat factor deficiencies when specific factor concentrates are available

 

 

 

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