scholarly journals Effect of Fresh Frozen Plasma Transfusion on Electrochemical Parameters of Blood Plasma in Patients with Severe Combined Trauma

2020 ◽  
Vol 16 (4) ◽  
pp. 4-13
Author(s):  
I. V. Goroncharovskaya ◽  
A. K. Evseev ◽  
A. K. Shabanov ◽  
V. V. Kulabukhov ◽  
A. N. Kuzovlev ◽  
...  

Purpose: to study the dynamics of blood plasma electrochemical parameters in patients with severe combined trauma before and after fresh frozen plasma (FFP) transfusions.Materials and methods. The open circuit potential (OCP) of platinum electrode and antioxidant activity of blood plasma were studied in 35 patients with severe combined trauma and 35 post-FFP samples with at least 6-month shelf life. The electrochemical parameters of patients’ blood plasma were analyzed before transfusion, and 1 hr. and 24 hrs. after transfusion.Results. OCP measured in FFP was found to be more positive vs. OCP measured in recipients' blood plasma in 34 out of 35 cases (97%). It has been shown that in patients with severe combined trauma, OCP increased from 5.047 [-7.553; 12.976] mV to 12.827 [-1.372; 24.764] mV and antioxidant activity decreased 24 hours after FFP transfusion from 16.979 [11.302; 20.946] µC to 13.551 [9.288; 18.405] µC. After FFP transfusion, there were no significant changes in clinical blood parameters.Conclusion. By measuring electrochemical parameters of blood plasma in patients with severe combined trauma before and after FFP transfusions, it was discovered that in spite of absence of changes in blood parameters by routine methods, there are changes in the condition of the antioxidant system of the body, which manifest in the bias of patients’ blood plasma OCP towards higher positive values and decreased antioxidant activity. Redox imbalance in the body might cause the oxidative stress development.

2019 ◽  
Vol 22 (8) ◽  
pp. 696-704
Author(s):  
Elizabeth T Mansi ◽  
Jennifer E Waldrop ◽  
Elizabeth B Davidow

Objectives The goals of this study were to classify the indications, risks, effects on coagulation times and outcomes of cats receiving fresh frozen plasma (FFP) transfusions in clinical practice. Methods This was a retrospective study of FFP transfusions administered in two referral hospitals from 2014 to 2018. Transfusion administration forms and medical records were reviewed. Information was collected on indication, underlying condition, coagulation times and signs of transfusion reactions. Seven-day outcomes after FFP administration were also evaluated when available. Results Thirty-six cats received 54 FFP transfusions. Ninety-four percent of cats were administered FFP for treatment of a coagulopathy. Twenty cats had paired coagulation testing before and after FFP administration. Eighteen of these cats had improved coagulation times after receiving 1–3 units of FFP. Eight of the 36 cats had probable transfusion reactions (14.8% of 54 FFP transfusions). These reactions included respiratory signs (n = 4), fever (n = 2) and gastrointestinal signs (n = 2). Five of the eight cats with probable reactions had received packed red blood cells contemporaneously. Overall mortality rate during hospitalization was 29.7%, with 52.8% (n = 19/36) of cats confirmed to be alive 7 days after discharge. Conclusions and relevance This retrospective study shows that FFP transfusions improve coagulation times in cats. Transfusion reactions are a risk, and risk–benefit ratios must be measured prior to administration and possible reactions monitored. In the study cats, the FFP transfusions appeared to be a tolerable risk given the benefit to prolonged coagulation times.


2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Mai Shinohara ◽  
Toyoyoshi Uchida ◽  
Takashi Funayama ◽  
Mika Watanabe ◽  
Makio Kusaoi ◽  
...  

Abstract Plasma exchange (PE), which directly removes some plasma thyroid hormones, is a treatment option for thyroid storm. However, the effect of PE has not been accurately assessed yet. Here we assessed the effect of PE in a patient with thyroid storm while taking into consideration the distribution of thyroid hormones in the extravascular space. A 51-year-old woman with thyroid storm underwent 2 PE procedures at our hospital. By measuring changes in thyroid hormone levels in plasma, fresh frozen plasma (FFP) used, and waste fluid during each 2.5-hour PE procedure, we calculated the efficiency of thyroid hormone removal based on the hypothesis that total thyroid hormone content before and after PE is the same. During the patient’s first PE procedure, the estimated thyroxine (T4) balance in the extravascular space (ΔX) was −70 μg, which corresponds to approximately 19% of T4 in the waste fluid. During the second PE procedure, ΔX was −131 μg, which corresponds to approximately 52% of T4 in the waste fluid. These data indicated that the source of removed T4 during PE varies. The amount of T4 removed from the extravascular space should be taken into account during assessment of the effect of PE in thyroid storm.


Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4682-4682
Author(s):  
Mei Sun ◽  
JIan Gu ◽  
Bin He ◽  
Xiao-Yan Xie ◽  
Bao-An Chen ◽  
...  

Abstract Abstract 4682 OBJECTIVE: To evaluate the effectiveness and safety of lower dose rituximab by adding fresh frozen plasma in the treatment of patients with idiopathic thrombocytopenic purpura (ITP). METHODS: A prospective study was performed at Subei People,Hospital Affiliated to Yang Zhou University involving the use of lower dose rituximab combining fresh frozen plasma in 15 patients who had previously been treated with steroids, intravenous immunoglobulin (IVIG) or splenectomy. Fifteen patients with refractory ITP which were unresponsive to or relapse after the above said treatment were treated with two hundreds millilitre of fresh frozen plasma (FFP) followed with rituximab (100 mg/m2 per week for four weeks) and oral Medrol (24mg per day). Whole blood cell count in all cases and B cells of CD19 (+)/CD20 (+) were detected in eight cases before and after rituximab therapy. RESULTS: Complete response (CR) was achieved in 7 patients (46.67%), response (R) in 13(86.67%), and non-response (NR) in 2 (13.33%). The median follow-up time was 4 weeks. The median response and CR time were 7 and 14 days, respectively. CD19 (+) CD20 (+) B cells significantly decreased (P < 0.01). There were no severe adverse effects during rituximab therapy. CONCLUSION: Lower dose rituximab by adding fresh frozen plasma is effective and safe for ITP. Our therapeutic regimen is superior to other relative studies; however, a randomized control trial is needed to confirm the results of our study. Disclosures: No relevant conflicts of interest to declare.


2003 ◽  
Vol 17 (5) ◽  
pp. 329-332 ◽  
Author(s):  
Axel Hittelet ◽  
Jacques Devière

The risk of procedure-related bleeding while taking anticoagulants needs to be weighed against the risk of thromboembolism from discontinuing these drugs. It is not necessary to adjust anticoagulation for low-risk procedures, such as upper endoscopy with biopsy, colonoscopy with biopsy or endoscopic retrograde cholangiopancreatography with stent insertion (but without sphincterotomy). Procedures that incur a high risk of bleeding include polypectomy, endoscopic sphincterotomy, laser therapy, mucosal ablation and treatment of varices. For these procedures, warfarin should be discontinued four to five days beforehand. Depending on the risk of thromboembolism, that is based on the nature of the underlying condition, the patient may require vitamin K and/or fresh frozen plasma (to ensure that coagulation parameters are within the normal range) or heparin infusions (to ensure that some degree of anticoagulation is maintained). Low molecular weight heparin is an alternative to unfractionated heparin for select cases with a high risk of thromboembolism. Warfarin therapy may generally be resumed on the night of the procedure and may be supplemented by heparin in patients with a high risk of thromboembolism. It is not necessary to discontinue acetylsalicylic acid or nonsteroidal anti-inflammatory drugs, when used in standard doses, for endoscopic procedures. There are insufficient data to make recommendations regarding newer antiplatelet drugs, such as ticlopidine or clopidogrel, but it is prudent to discontinue these medications seven to 10 days before a high-risk procedure.


Transfusion ◽  
2010 ◽  
Vol 51 (6) ◽  
pp. 1278-1283 ◽  
Author(s):  
Johanna C. Wiersum-Osselton ◽  
Rutger A. Middelburg ◽  
Erik A.M. Beckers ◽  
Anita J.W. van Tilborgh ◽  
Pauline Y. Zijlker-Jansen ◽  
...  

2012 ◽  
Vol 116 (3) ◽  
pp. 716-728 ◽  
Author(s):  
Anthony M.-H. Ho ◽  
Peter W. Dion ◽  
Janice H. H. Yeung ◽  
John B. Holcomb ◽  
Lester A. H. Critchley ◽  
...  

Observational studies on transfusion in trauma comparing high versus low plasma:erythrocyte ratio were prone to survivor bias because plasma administration typically started later than erythrocytes. Therefore, early deaths were categorized in the low plasma:erythrocyte group, whereas early survivors had a higher chance of receiving a higher ratio. When early deaths were excluded, however, a bias against higher ratio can be created. Survivor bias could be reduced by performing before-and-after studies or treating the plasma:erythrocyte ratio as a time-dependent covariate.We reviewed 26 studies on blood ratios in trauma. Fifteen of the studies were survivor bias-unlikely or biased against higher ratio; among them, 10 showed an association between higher ratio and improved survival, and five did not. Eleven studies that were judged survivor bias-prone favoring higher ratio suggested that a higher ratio was superior.Without randomized controlled trials controlling for survivor bias, the current available evidence supporting higher plasma:erythrocyte resuscitation is inconclusive.


2009 ◽  
Vol 94 (2) ◽  
pp. 477-482 ◽  
Author(s):  
Ingrid Hansen-Pupp ◽  
Eva Engström ◽  
Aimon Niklasson ◽  
Ann-Cathrine Berg ◽  
Vineta Fellman ◽  
...  

Abstract Context: Preterm birth is followed by a decrease in circulatory levels of IGF-I and IGF binding protein (IGFBP)-3, proteins with important neurogenic and angiogenic properties. Objective: Our objective was to evaluate the effects of iv administration of fresh-frozen plasma (FFP) from adult donors on circulatory levels of IGF-I and IGFBP-3 in extremely preterm infants. Design, Setting, and Patients: A prospective cohort study was performed in 20 extremely preterm infants [mean (sd) gestational age 25.3 (1.3) wk] with clinical requirement of FFP during the first postnatal week. Sampling was performed before initiation of transfusion, directly after, and at 6, 12, 24, and 48 h after completed FFP transfusion. Main Outcome Measures: Concentrations of IGF-I and IGFBP-3 before and after transfusion of FFP were determined. Results: FFP with a mean (sd) volume of 11 ml/kg (3.1) was administered at a median postnatal age of 2 d (range 1–7). Mean (sd) IGF-I and IGFBP-3 concentrations in administered FFP were 130 (39) and 2840 μg/liter (615), respectively. Immediately after FFP transfusion, mean (sd) concentrations of IGF-I increased by 133% from 11 (6.4) to 25 μg/liter (9.3) (P &lt; 0.001) and IGFBP-3 by 61% from 815 (451) to 1311 μg/liter (508) (P &lt; 0.001). Concentrations of IGF-I and IGFBP-3 remained higher at 6 (P &lt; 0.001, P = 0.009) and 12 h (P = 0.017, P = 0.018), respectively, as compared with concentrations before FFP transfusion. Typical half-life of administrated IGF-I was 3.4 h for a 1-kg infant. Conclusion: Transfusion of FFP to extremely preterm infants during the first postnatal week elevates levels of IGF-I and IGFBP-3.


2021 ◽  
Author(s):  
Robert Klanderman ◽  
Niels van Mourik ◽  
Dorus Eggermont ◽  
Anna-Linda Peters ◽  
Pieter-Roel Tuinman ◽  
...  

Abstract Background: Transfusion-related acute lung injury (TRALI) is a severe complication of plasma transfusion, though use of solvent/detergent pooled plasma (SDP) has nearly eliminated reported TRALI cases. The goal of this study was to investigate TRALI incidence in the intensive care unit (ICU) following replacement of quarantined, male-only, fresh frozen plasma (qFFP) by SDP for routine use. Methods:We conducted a retrospective multicenter observational before-after cohort study during two six-month periods, before (April to October 2014) and after introduction of SDP (April to October 2015), taking into account a six-month wash-out period. One secondary and four tertiary academic hospitals participated.Results:Admitted to the ICU were 8944 patients during both inclusion periods. 1171 qFFP units were transfused in 376 patients in the qFFP, and 396 during the before and after periods respectively in the SDP period. A full patient chart review was performed in 300 patients that received ≥1 units of plasma and had a PaO2/FiO2-ratio (P/F-ratio) <300 within 24 hours. Ten cases of TRALI occurred during the qFFP and nine cases during the SDP period, in which plasma was transfused concomitantly with other products, or alone. The incidence was 0.85% (CI95%: 0.33% – 1.4%) per unit qFFP and 0.45% (CI95%: 0.21% - 0.79%, p = 0.221) per SDP-unit. One instance of TRALI occurring after a single SDP unit. Mortality was 70% for patients developing TRALI in the ICU compared to 22% in all patients receiving at least one plasma transfusion. Conclusion:Implementation of SDP lowered the incidence of TRALI in which plasma products were implicated, though not significantly. TRALI can still occur as a result of SDP transfusion. Developing TRALI in the ICU was associated with high mortality rates, therefore clinicians should remain vigilant.


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