Product Description
Cryo-depleted Plasma is the supernatant remaining after the cryoprecipitate has been removed from fresh frozen plasma (FFP). It contains most clotting factors in similar amounts of FFP but is deficient in Factor VIII, fibrinogen, von Willibrand Factor (VWF), FXIII and fibronectin.
|
| Cryo-depleted Plasma | 255mL + 10% |
| Cryo-depleted Plasma Apheresis | 550mL + 10% |
Indications for Use
- Plasma exchange for TTP
- May be used as an alternative to FFP for the treatment of coagulopathy where there is no significant reduction in Factor VIII, fibrinogen, Factor XIII or VWF, e.g. it may be used for rapid temporary warfarin reversal in patients requiring emergency surgery and in warfarin overdose with life-threatening bleeding in addition to Prothrombin Complex Concentrates (vitamin K dependent factor concentrates eg Prothrombinex-VF). For extended warfarin reversal, vitamin K may be recommended.
Precautions
- Consider the use of cryo-depleted plasma. Is a transfusion required?
- Do not use cryo-depleted plasma when specific therapy is available and more appropriate e.g. vitamin K specific factor concentrates.
- Do not use for blood volume replacement where this can be achieved safely using other volume expanders eg 0.9%, Hartmann’s solution, Haemaccel, Gelofusin.
- Caution is needed with volume. Volume overload is a particular risk in the very young, the elderly and in patients with cardiovascular disease.
Compatibility
TESTING - blood group on record.
Compatibility testing is not required however ABO compatible plasma should be used wherever possible. Group AB plasma can be used for all ABO groups in an emergency. Restrict Group O plasma to Group O recipients.
ABO FFP/Cryo-depleted plasma should be ABO compatible.
|
| A | A, AB |
| B | B, AB |
| AB | AB |
| O | O, AB, A B |
Note: AB FFP/Cryo-depleted plasma may be used for all patient ABO groups.
Rh(D)
FFP/Cryo-depleted plasma may be transfused without regard to Rh(D) type.
Dosage and Administration
Volume depends on clinical situation, patient size and laboratory tests. General guide is 10 – 15mL/kg per dose.
For patients with specific factor deficiencies, always consider specific replacement therapy rather than cryo-depleted plasma e.g. Factor VIII for haemophilia A.
Once thawed use immediately or store at 2 - 6°C for 24 hours. Alternately, thawed cryo-depleted plasma may be allocated by a medical practitioner for a designated patient under his or her care and stored at 2 - 6°C for up to 5 days.
Transfusion Set-up
Note: this is a guide only – individual hospital guidelines should be followed.
- Mix gently but thoroughly by inversion prior to use.
- Administer through a new IV blood giving set incorporating a 170-200 micron filter (large particle filter which only removes aggregates and other large particles).
Patient Monitoring
Note: this is a guide only – individual hospital guidelines should be followed.
Commence the transfusion as soon as possible after thawing of cryo-depleted frozen plasma (within 30 minutes of removal from approved storage).
Check patient vital signs (pulse rate, respiration rate, blood pressure and temperature) at the start of transfusion AND at least after 15 minutes, at the end of the transfusion AND if there is ANY reaction. Record observations in the patient’s notes.
How Long Should a Transfusion Take?
- Transfusion of each unit may proceed as fast as tolerated but should be completed within four hours of commencing the transfusion.