Fresh frozen plasma (FFP) is the most commonly used source of coagulation factor replenishment. FFP is prepared by centrifugation of carefully obtained whole blood and contains fibrinogen at a variable concentration of 0.6 g/300mL unit or 2.0 g/L (range = 0.9 to 3.2g/L), as well as albumin, protein C, protein S antithrombin and tissue factor pathway inhibitor (Theusinger et al., 2011; Kelley & Guzman, 2018). It is stored by freezing to less than -25°C within 8 hours of collection (Stanworth & Tinmouth, 2009).
FFP can be used to treat fibrinogen deficiencies; however, it has several limitations including a low fibrinogen concentration (Theusinger et al., 2011). Large volumes would therefore need to be administered in the case of severe hypofibrinogenemia, increasing the risk of transfusion related complications such as TRALI (transfusion-related acute lung injury) (Benson et al., 2009). It is therefore not recommended as a treatment option for fibrinogen replenishment and should only be used in the absence of cryoprecipitate or fibrinogen concentrate (Franchini & Lippi, 2012; McDonnell, 2018; Spahn et al., 2019).
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