Do you use Thawed Plasma, 5 day for Massive transfusion?

[conwaysbb]

Our facility is a level 2 Trauma Center which is revising our Massive Transfusion Protoclo. The Trauma department wants to use Massive Transfusion Packs (MTPs) with the first MTP as follows:

a. RBC, 6 units of type O RBC uncrossmatched unless 4 units are requested.

b. FFP 4 units, unless 2 units are requested.

c. Single donor platelet

However, as I have informed them, thawing of the FFP will take time, anywhere from 30-45 minutes depending on the number of units needed and the size of the FFP units.

As I have seen several posts about using thawed plasma, 5 day as a subsitute for FFP, we have suggested this option for the initial MTP followed by immediate thawing of other FFP when the blood type is known and having it available if a subsequent MTP pack is requested. If a subsequent MTP is not requested then we would just convert these FFP units thawed to Thawed Plasma, 5 day.

To further support our recommendations I need to give them names of other institutions that are using this option , as well as, any articles individuals would be able to reference that support this option.

Please post here or e-mail me if you would like to respond

my e-mail is conwayM at sjhmc.org

Thanking you in advance

Mike Conway

[sharlene]

We recently implemented thawed plasma 5 day because of our new Massive Blood Transfusion Protocol and the cardiac surgeons wanted it available without having to wait for it to thaw. I will email you with details.

[Likewine99]

conwaysbb, our MTP is very similar to yours and we went to 5 day plasma about 2 years ago and have virtually zero waste. The trauma surgeon was perfectly happy with this as were the other physicians on staff at our place.

I have some articles on file at work, e-mail me @ Mary_Mendel@ssmhc.com

[Kip Kuttner]

My blood center services two level 2 and one level 3 trauma centers. They have gone to the the 5 day plasma. While it is always transfused, my issue is regarding AB plasma which is difficult to obtain since we are only using units from males to make FFP. Please try to work with your supplier to assure product is available.

[scodina]

I have responded to this post off-line, but I do want to refer the rest of the group to the following journal article:

Yazer MH, Cortese-Hassett A, and Triulzi DJ. Coagulation factor levels in plasma frozen within 24 hours of phlebotomy over 5 days of storage at 1-6C. Transfusion 2008;48:2525-2530.

Stephanie

[Cathy]

We have recently switched to 5 day plasma. It's been great for the MTPs or even for routine orders. We use what we have thawed and thaw more. We go right to the 5 day expiration.

[bxcall1]

Our Transfusion Service Medical director and the Transfusion Committee have decided that 24hr plasma and 5 day plasma are pretty much equivalent (with the exception of a few rare cases).

We use them interchangebly to fill 'FFP' requests.