How much Fresh Frozen Plasma (FFP) to give?

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Last updated: February 7, 2025View editorial policy

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From the Research

Dosage of Fresh Frozen Plasma (FFP)

The optimal dosage of FFP to administer is not clearly defined, as it depends on various factors such as the patient's condition, the severity of bleeding, and the presence of coagulopathy.

  • A study published in 2007 suggested that FFP should be given earlier to patients requiring massive transfusion, with a ratio of FFP to red blood cells (RBC) of 1:1 1.
  • Another study published in 2024 found that a high FFP to RBC ratio (>1) was associated with lower in-hospital mortality in patients with severe blunt trauma 2.
  • However, a study published in 2006 found that the change in international normalized ratio (INR) per unit of FFP transfused can be predicted by the pretransfusion INR, and that FFP transfusion does not reliably reduce the INR in patients with an INR < 1.7 3.
  • A review of 15 trials published in 2015 found that there was no difference in mortality or blood loss between patients who received FFP and those who did not, although the quality of the evidence was generally low 4.

Administration Guidelines

  • The American Journal of Clinical Pathology study published in 2006 suggested that FFP transfusion is not necessary for patients with an INR < 1.7, as it does not reliably reduce the INR 3.
  • The Journal of Trauma study published in 2007 recommended a FFP to RBC ratio of 1:1 for patients requiring massive transfusion 1.
  • The JAMA Surgery study published in 2024 suggested that a high FFP to RBC ratio (>1) may be beneficial for patients with severe blunt trauma 2.

Patient-Specific Factors

  • The decision to administer FFP should be based on individual patient factors, such as the presence of bleeding, coagulopathy, and the results of coagulation tests 5, 1, 3.
  • The patient's underlying condition, such as cardiovascular surgery or trauma, should also be taken into account when deciding on FFP administration 1, 2, 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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