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