Indications for Fresh Frozen Plasma (FFP) in Dengue Fever

Primary Indications for FFP in Dengue Fever

The American Society of Anesthesiologists recommends FFP transfusion for correction of excessive microvascular bleeding in the presence of prolonged PT (>1.5 times normal) or INR >2.0, or aPTT >2 times normal 1, 2
FFP should be considered when there is active bleeding with coagulation abnormalities, as suggested by the American Society of Anesthesiologists 1, 3
FFP may be used for correction of excessive microvascular bleeding secondary to coagulation factor deficiency in patients who have received massive transfusions (>70 ml/kg) and when coagulation tests cannot be obtained quickly, according to the American Society of Anesthesiologists 1

The American Society of Anesthesiologists recommends FFP should be given in doses of 10-15 ml/kg to achieve a minimum of 30% plasma factor concentration 1, 4
The typical volume of one unit of FFP is 250-300 ml, as stated by Praxis Medical Insights 4
FFP should be ABO compatible with the recipient, as recommended by the Anaesthesia society 5, 4
Coagulation tests (PT/INR and aPTT) should be obtained before FFP administration whenever possible, according to the American Society of Anesthesiologists 1, 2

FFP should not be used to correct laboratory clotting abnormalities in the absence of bleeding or planned invasive procedures, as stated by the Critical Care Medicine society 6, 7, 8
FFP is not indicated solely for augmentation of plasma volume or albumin concentration, according to the American Society of Anesthesiologists 1, 2

Assess for active bleeding, then check coagulation parameters (PT/INR, aPTT) and consider planned invasive procedures, as recommended by the Anaesthesia and Critical Care Medicine societies 1, 2, 5, 6, 7, 8
If PT >1.5 times normal, INR >2.0, or aPTT >2 times normal, FFP is indicated, according to the American Society of Anesthesiologists 1, 2

Using FFP as volume expander instead of crystalloids or colloids is not recommended, as stated by the American Society of Anesthesiologists and Praxis Medical Insights 1, 4
Failing to check coagulation parameters before FFP administration is a common pitfall, according to the American Society of Anesthesiologists 1
Administering inadequate doses of FFP (less than 10-15 ml/kg) is not recommended, as stated by the American Society of Anesthesiologists and Praxis Medical Insights 1, 4
Transfusing FFP to correct mild coagulation abnormalities in non-bleeding patients is not indicated, according to the Critical Care Medicine society 7, 8