Plasma is the largest part of our blood as it makes up more than half (about 55%) of the overall content[1]. Plasma is a light-yellow liquid when separated from the rest of the blood and carries water, salts and enzymes. More importantly, plasma contains essential clotting factors to help stop bleeding[2]. For this reason, plasma is used as treatment that can help save the lives of people suffering from burns, shock, trauma, and other medical emergencies[1].

 

Freeze-dried plasma (FDP) is in powder form in a glass vial stored at room temperature[2]. It is mixed with water to form a yellow liquid before it is given intravenously to a patient. Fresh-frozen plasma (FFP), on the other hand, is stored at -30˚C and needs to be thawed before infusion[3]. Regarding coagulation and clotting capacities, studies show that FDP is equivalent to FFP[4].

 

Owing to FDP’s logistical advantages in terms of storage and reconstitution time compared to FFP, FDP is used in an increasing number of countries at the moment in military and prehospital settings[4]. Prehospital healthcare providers believe that carrying plasma along with blood on prehospital vehicles would improve patients’ chances of reaching the hospital alive as the majority of potentially preventable deaths after trauma are related to hemorrhage with the largest number of deaths occurring before hospital arrival[2][5].

 

However, it is still recommended that all blood products need to be warmed up before administering to a patient as infusion of fluid below the body temperature decreases core temperature, thereby causing hypothermia, which results in significantly increased risk for death[6].

 

REFERENCES

[1] What is plasma? https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=160&ContentID=37

[2] The HEMS charity has been carrying packed red blood cells since August 2015 and is now carrying two units of plasma, which will be used with two units of O negative blood https://www.airmedandrescue.com/latest/news/wiltshire-air-ambulance-enhances-its-life-saving-abilities-addition-plasma

[3] Khawar H, Kelley W, Stevens JB, et al. Fresh Frozen Plasma (FFP) [Updated 2020 Oct 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513347/

[4] Feuerstein, Solveig & Skovmand, Kamilla & Møller, Ann & Wildgaard, Kim. (2020). Freeze‐dried plasma in major haemorrhage: a systematic review. Vox Sanguinis. 115. 10.1111/vox.12898.

[5] Eastridge BJ, Holcomb JB, Shackelford S. Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury. Transfusion. 2019 Apr;59(S2):1423-1428. doi: 10.1111/trf.15161. PMID: 30980749.

[6] Bennett BL, Giesbrect G, Zafren K, Christensen R, Littlejohn LF, Drew B, Cap AP, Miles EA, Butler FK Jr, Holcomb JB, Shackelford SA. Management of Hypothermia in Tactical Combat Casualty Care: TCCC Guideline Proposed Change 20-01 (June 2020). J Spec Oper Med. 2020 Fall;20(3):21-35. PMID: 32969001.