blood products- FFP, cryoprecipitate, prothrombin complex

Question 1

Fresh frozen plasma (FFP)

Answer 1

• most suited for ‘clinically significant’ but without ‘major haemorrhage’ in patients with a prothrombin time (PT) ratio or activated partial thromboplastin time (APTT) ratio > 1.5
• typically 150-220 mL
• can be used prophylactically in patients undergoing invasive surgery where there is a risk of significant bleeding

Question 2

Cryoprecipitate

Answer 2

• contains concentrated Factor VIII:C, von Willebrand factor, fibrinogen, Factor XIII and fibronectin, produced by further processing of Fresh Frozen Plasma (FFP). Clinically it is most commonly used to replace fibrinogen
• much smaller volume than FFP, typically 15-20mL
• most suited for patients for ‘clinically significant’ but without ‘major haemorrhage’ who have a fibrinogen concentration < 1.5 g/L
• example use cases include disseminated intravascular coagulation, liver failure and hypofibrinogenaemia secondary to massive transfusion. It may also be used in an emergency situation for haemophiliacs (when specific factors not available) and in von Willebrand disease
• can be used prophylactically in patients undergoing invasive surgery where there is a risk of significant bleeding where the fibrinogen concentration < 1.0 g/L

Question 3

Prothrombin complex concentrate

Answer 3

used for the emergency reversal of anticoagulation in patients with either severe bleeding or a head injury with suspected intracerebral haemorrhage

can be used prophylactically in patients undergoing emergency surgery depending on the particular circumstance