Plasma_Dosage_guideline v.1

Plasma Dosage calculation helps in dosing of plasma for transfusion in patients with active bleeding.

Maryam Razavi

maryam.razavi@cambio.se

CambioCDS

To assist clinicians with plasma dosing calculation for transfusion in patients with active bleeding.

Use to correct deficiencies of clotting factors, for which a specific concentrate is not available, in patients with active bleeding. Formula: Plasma Dosage: desired plasma dosage, mL/kg × weight, kg FFP units for transfusion: Plasma Dosage/Unit volume, units Note: 1. Plasma must be ABO-compatible with the recipient. 2. Desired plasma dosage ranges from 10 to 20 mL/kg. 3. This dose is expected to increase the level of coagulation factors by 20% immediately after infusion. 4. A recommended standard dose of FFP is 10 mL/kg, but doses up to 15 or 20 mL/kg may be justified based on the clinical situation. 5. Transfusion of less than the therapeutic dose of plasma should be discouraged. 6. Plasma should be infused as soon as possible after it is thawed and never be refrozen. 7. Precise prediction of the amount of plasma needed to be transfused to correct a particular coagulopathy is not currently possible. Thus, post-transfusion repetition of the coagulation test that prompted the transfusion is warranted. Selection of the ABO phenotype: ABO phenotype of the recipient ABO phenotype of units to transfuse (in order of preference) O O, A, B, AB A A, AB B B, AB AB AB

Not to use in absolute contraindications (documented intolerance to plasma or components, congenital IgA deficiency with anti-IgA antibodies, etc.), relative contraindications (heart failure, pulmonary edema, etc.) and, ABO-incompatibility. Plasma dosage cannot be used to provide comprehensive or definitive transfusion information. Inappropriate indications include transfusion in patients without active bleeding or invasive procedures, correction of minimal elevations in INR (i.e., INR <1.7), expansion of circulatory volume, hypoproteinemia, correction of immune deficiencies, transfusion for nutritional purposes, correction of congenital or acquired deficiencies of clotting factors in the absence of hemorrhage, or correction of disorders of hemostasis in patients with chronic liver disease who are not bleeding.

1. Liumbruno G, Bennardello F, Lattanzio A, Piccoli P, Rossetti G. Recommendations for the transfusion of plasma and platelets. Blood Transfus. 2009;7(2):132-50. 2. Roback JD. Technical Manual. American Association of Blood Banks (AABB); 2014.

OBSERVATION.body_weight.v2, OBSERVATION.plasma_dosage.v0