Types of preparation and temperature conditions
Depending on the processing technology, three main forms of the preparation are distinguished. Each of them has strict application frameworks and expiration dates.
- Liquid (native): This is the freshest preparation. It must be used immediately after separation from the cellular mass. The maximum allowable waiting time is only 2–3 hours.
- Frozen: Allows for building up supplies in blood banks. If the temperature is maintained at -25 °C, the preparation retains its therapeutic properties for up to 90 days. When frozen down to -10 °C, the shelf life is reduced to 30 days. Immediately before administration, such a medium must be thawed at a physiological temperature of 37–38 °C.
- Dry (lyophilized): Available in glass vials with dosages from 50 to 250 ml (sometimes up to 500 ml). It is produced from frozen plasma by vacuum drying, which radically increases the shelf life up to five years.
Indications and contraindications for transfusion
The main goal of administering this blood component is to compensate for massive plasma loss during a critical decrease in circulating blood volume (CBV).
Main indications:
- Various types of shock (traumatic, operative).
- Emergency bleeding cessation.
- Blood loss exceeding 25% of CBV (in such cases, plasma transfusion must be combined with the administration of whole blood or packed red blood cells).
- Burn disease.
- Severe purulent-inflammatory processes, generalized sepsis, and peritonitis.
- Hemophilia.
- Need for comprehensive parenteral nutrition.
The only strict contraindication to the procedure is the presence of severe allergic diseases in the patient, as foreign proteins can provoke an anaphylactic reaction.
Administration rules and dosages
In routine practice, therapeutic doses for adult patients are 100, 250, or 500 ml. When dealing with a shock state, infusion volumes are increased to 500–1000 ml.
Key safety rule: transfusion is performed exclusively taking into account the donor's and recipient's blood group according to the ABO system. Before starting the infusion, the physician must perform a biological compatibility test.
In emergency situations when there is no time for blood typing, protocols permit administering AB(IV) group plasma to absolutely all recipients. This is because blood group AB lacks group agglutinins.
Specifics of using dry plasma
Lyophilized powder requires preliminary preparation. Before intravenous administration, it is reconstituted with distilled water or isotonic sodium chloride solution, achieving complete dissolution.
Indications for the dry form are similar to native and frozen plasma, but there is one important exception. The dry preparation is completely ineffective for hemostatic purposes. Due to processing, it loses clotting factors, so it cannot be used to stop bleeding. The requirement to perform a biological test for this form remains strictly mandatory.
Signs of product unsuitability
Before connecting the infusion set, the physician must carefully and visually evaluate the vial. It is forbidden to use the transfusion medium if the following signs are detected:
- Change of the normal liquid color to a dull grayish-brown hue.
- Formation of massive whitish clots or floating flakes.
- Appearance of an unpleasant odor after opening the vial.
Briefly: answers to topical questions
How exactly is the biological compatibility test technically performed before plasma infusion?
Technically, the biological test is a mandatory condition before plasma infusion and is performed at the very beginning of the transfusion. The first 15–20 ml of the administered preparation are used for the study. Further technical details of performing the test specifically for plasma are absent in the sources due to text cutoff.
What post-transfusion complications are possible after blood plasma transfusion?
The cited sources do not list specific post-transfusion complications specifically after plasma transfusion. It is indicated that sensitization with the formation of antibodies to plasma proteins can lead to severe complications during repeated transfusions or pregnancy. Transfusion-related acute lung injury (TRALI) is also described, which may be accompanied by increased pulmonary capillary permeability, noncardiogenic pulmonary edema, and respiratory failure.
Group AB(IV) is a universal savior: its plasma contains no agglutinins, so in an emergency situation it can be given to everyone.
Class and exam questions
Can dry plasma be used to stop bleeding?
No. During lyophilization (vacuum drying), clotting factors are destroyed, so this preparation has no hemostatic effect.
In which case is it permitted to transfuse plasma without considering the patient's blood group?
Only in extreme situations is it permitted to transfuse AB(IV) group plasma, as it contains no agglutinins.
Is it mandatory to perform a biological test before administering dry plasma?
Yes, the biological test is strictly mandatory before administering any form of plasma (native, frozen, or dry).
What else to study on this topic
- Technique of the biological test
- Pathophysiology of traumatic and operative shock
- Burn disease: stages and principles of CBV restoration
- ABO system and rules for blood component compatibility
- Hemophilia: coagulation disorders and replacement therapy
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Other topics in the section "CHAPTER 6. BLOOD TRANSFUSION"
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