Plasma

This largest component of human blood contains 
1. All haemostatic factors
2. Albumin
3. Globulin
4. Water

Indications of plasma transfusion

1. DIC
2. During Trauma care
3. Procedure on liver disease patient
4. Active haemorrhage
5. Secondary haemorrhage 
6. As prophylaxis before big surgery and invasive procedure
7. Coagulopathies  
8. Deficiencies of 2,7,9,10 coagulation factors
9. Hypoalbuminaemia
10. Severe pancreatitis

Contra indication of plasma transfusion

In heparin induced hemorrhage (will enhance the heparin effect)

Transfusion method

Dose. 10 to 20 ml / kg
May be repeated after 8 to 10 hrs as needed
Important facts
1. One bag contains 150 to 175 ml of plasma
2. Plasma can not be stored in nursing home refrigerator
3. Plasma should be transfused with in 4 to 6 hrs of issue from blood bank
4. Transfusion of colloids should be stopped during plasma transfusion
5. Matching is required
6. Reactions can be there as with blood
7. Only filter blood set to be used for transfusion
8. Do not transfuse with ordinary blood set

                                                                                                                                              
Hypoalbuminaemia

Plasma contains 0.025 gm / ml of albumin
Optimum requirement is 2 to 2.5 g / dl
For this 10 plasma bags are to be transfused per day for 4 to 5 days
Keep in mind the overload
Can transfuse continuously  for 12 or 24 hrs
For raise of 0.5 g  / dl (5 g / liter) give 20 to 30 ml / kg / day

Human serum albumin ( protein preparations ) 

Is made from plasma
Contains 10 times more albumin than plasma
Contains more risk of sensitivity reactions
To reduce reactions dilute to 10 percent solution with 0.9 percent saline, transfuse with blood set, transfuse in 12 hrs

Indications
1. All critical patients
2. Severe sepsis
3. Before surgery

Please note

HSA is not replacement for plasma but is adjuvant
HSA does not contain other plasma constituents ( globulin, antiprteas, coagulation factors)
If volume overload is problem then use HSA with Plasma 

Reactions

As of blood 




Dr. S.k.Bhasin