Imagine, someone is bleeding profusely in a major road accident. Or during a major surgery, a lot of blood is lost unexpectedly. At such times, if the natural blood clotting process in our body does not work properly, it can be a major threat to life. It is in such serious cases that we talk about the life-saving treatment called Fresh Frozen Plasma, or FFP as we all know it. Perhaps when your doctor mentions this name, you may feel a little scared and curious. So today, let's talk very simply and friendly about what this FFP is, who is it given to, how, and what are its benefits and risks.
Simply put, what is Fresh Frozen Plasma (FFP)?
Our blood is not made up of just one thing. It has several components. Think of it like a fruit salad. Just like there are different kinds of fruit in it, our blood also has several main components.
- Red blood cells: These are what carry oxygen throughout our bodies.
- White blood cells: These are our army that fights germs that cause disease.
- Platelets: When you get a cut, they are the first thing that comes to stop the bleeding and cover the wound, like a small plaster.
- Plasma: This is the main character of our story. Plasma is the yellow liquid part of the blood. All the cells mentioned above float along this 'river' called plasma.
This plasma is not just water. It contains many proteins, hormones, and salts that are essential for our lives. The most important of these are proteins called "clotting or coagulation factors."
Think of these clotting factors as a team of little engineers. If a blood vessel is injured or ruptured, these engineers, along with the platelets mentioned above, quickly form a mesh around the area, like a 'dam', completely stopping the bleeding. If this process doesn't work properly, even a small wound can cause excessive bleeding.
FFP is the process of removing all other cells from a person's donated blood, separating only this precious plasma. Then, to preserve those precious 'engineers', that is, the clotting factors, the blood is taken and deep-frozen at a temperature of -18 degrees Celsius or even lower within 8 hours. That's where the name 'Fresh Frozen' comes from.
Who really needs FFP treatment?
FFP is not a treatment that is given to every person who bleeds. It is a valuable treatment that doctors use in a few specific cases, when other treatments are not sufficient. Let's see what those cases are.
| When treatment is needed | To explain simply... |
|---|---|
| Heavy bleeding (Massive Blood Loss) | In times like a major car accident, a fall from a height, or a complex surgery, a large amount of blood is suddenly removed from the body. At this time, blood clotting factors are also greatly reduced. At that time, FFP is given to restore those reduced factors and control bleeding. |
| Deficiencies of blood clotting factors (Clotting Factor Deficiencies) | Some people have congenital diseases. An example is hemophilia . In these diseases, some of the factors needed for blood clotting are not produced in the body. Also, this problem occurs in people with liver disease . Because these clotting factors are mostly produced by the liver. When blood is given to such people, FFP is used to provide those deficient factors. |
| For those taking blood-thinning medications such as Warfarin | Warfarin is a medication that prevents blood clotting, given for conditions such as heart disease. If someone taking this medication has an accident and starts bleeding, it can be very difficult to stop. Even if vitamin K is given for this, it takes time to work. Therefore, as a quick solution, FFP is given to provide the necessary clotting factors directly. |
| A rare condition called TTP (Thrombotic Thrombocytopenic Purpura) | This is a very rare and dangerous disease. It causes blood clots to form in the small blood vessels of the body. By giving FFP, the body can restore an enzyme that is missing and control the disease. |
Are there other types of FFP?
Yes, there are several types of FFP, each with slight differences in the way it is made and the time it is made. You may have heard names like `PF24` or `Cryo-poor plasma`. But these names are not really important to you. These are technical details that are important to the doctors and the lab staff. They will choose the type of plasma that is exactly right for your condition. So you don't need to worry about that.
How is FFP treatment given? Is it painful?
FFP treatment is usually done in a hospital. It's not a major surgery. It's a simple procedure, like giving a saline solution.
1. Preparation: First, take the FFP bag from the freezer and place it in a special hot water bath until it reaches body temperature. This cannot be microwaved, as doing so will destroy the valuable proteins in it.
2. Inserting the IV line: Next, a nurse or doctor will insert a small cannula into a vein in your arm. This is similar to getting a needle inserted to give you saline. Aside from a slight stinging sensation, there is no significant pain.
3. Giving the plasma: Now the bag containing the diluted yellow plasma is connected to the IV line. Then it is slowly infused into your body through your vein. One FFP bag contains about 200-250 milliliters. It takes about 30 to 45 minutes for it to enter your body. The doctor will decide how many bags to give you depending on the severity of your condition.
4. Monitoring: During this treatment, a nurse will sit next to you and constantly check your blood pressure, heart rate, and body temperature . They are very attentive to any allergic reactions. So you are not alone, and someone is always watching you.
5. Tests: Before and after FFP is given, blood samples are taken from you and tests such as ``PT/INR test`` and ``PTT test`` are done to check the speed of blood clotting. This allows them to see how successful the treatment is.
The most important thing is that if you experience any discomfort, itching, or difficulty breathing during this process, tell the nurse or doctor immediately.
Can FFP be given to someone of any blood type?
This is a very important question. We generally know that when donating blood, blood types must match. When donating red blood cells, we know that type O blood is a "universal donor" that can give to anyone.
But when it comes to donating plasma, this story is completely different!
In plasma, plasma from someone with blood type AB is the universal donor , which can be given to someone with any blood type.It happens. Also, someone with type O blood can only receive type O plasma.
But don't worry about this. In an emergency, if your blood type is not known, doctors and blood bank staff will choose the safest option for everyone to give you plasma. They always try to give you plasma that matches your blood type.
What are the benefits and potential risks of FFP treatment?
Like any medical treatment, FFP treatment has benefits and very small risks.
The main advantage:
The biggest and only advantage of this is that it is a life-saving treatment. In cases of uncontrollable bleeding, FFP can provide the necessary clotting factors, stop the bleeding, and save a patient's life. This is the most valuable thing about this treatment.
Possible risks (Complications):
It is important to remember that these risks are very rare. Since blood banking services in Sri Lanka are of the highest standard, every step is taken to minimize these risks.
| Risk | That means... |
|---|---|
| Allergies (Allergic Reactions) | Sometimes the body can react to the plasma received from outside. This can cause minor symptoms such as bruising and itching. These can usually be quickly controlled with medication. |
| Infections (Infections) | This risk is now very, very low. Because everyone who donates blood is thoroughly tested for diseases like HIV, Hepatitis B, and C. So there is no need to be too afraid of this risk. |
| TRALI (traumatic lung injury) (Transfusion-Related Acute Lung Injury) | This is very rare but serious.Condition. When some of the substances in the plasma don't work well with your body, your lungs fill with water and it becomes difficult to breathe. This usually happens within 6 hours of receiving the plasma. |
| TACO (fluid overload) (Transfusion-Associated Circulatory Overload) | Especially for someone with heart disease or kidney disease, when a large amount of fluid is injected into the body at once, the heart may not be able to handle it. This can increase blood pressure and cause difficulty breathing. Doctors are aware of this and control the rate at which plasma is given. |
When do you need to talk to the doctor? Do you need to go to the ETU?
You will be discharged from the hospital only after it is confirmed that you are completely safe. However, some side effects may occur after you go home.
Tell your doctor if you experience these symptoms:
If you feel anything like this after you go home, call the hospital that treated you without delay, or tell your doctor.
- If you feel feverish and cold
- If you develop an itch, rash, or blister on your body
- If nausea and vomiting go away
- If you feel dizzy or lightheaded
- If you have back pain
If you experience these symptoms, go to the ETU immediately!
The following symptoms are a medical emergency . They may be signs of the serious conditions TRALI or TACO mentioned above. They can appear within 6 hours of receiving plasma.
- Difficulty breathing
- Heart palpitations
- Fever
If you have any of these symptoms, go to the nearest hospital's Emergency Department (ETU) immediately without waiting.
Take-Home Message
- FFP is the liquid portion of donated blood that is rich in proteins needed for blood clotting.
- It is mainly used to control excessive bleeding and treat people with blood clotting disorders.
- This is a very valuable treatment that can save lives.
- The treatment is given in a hospital, under medical supervision, in a simple way, like giving a saline solution.
- As with all treatments, there are small risks, but doctors will prescribe this treatment after considering the benefits and risks. Serious side effects are very rare.
- If you experience difficulty breathing, a rapid heartbeat, or fever after treatment, consider it an emergency and go to the hospital's Emergency Department (ETU) immediately.
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