Evaluation of bacterial growth, effects on albumin, and coagulation factors in canine fresh frozen plasma administered as continuous rate infusion exposed to room temperature for 12 hours

Abstract

ObjectivesTo determine the risk of bacterial growth and to analyze the stability of albumin and coagulation factors in canine fresh frozen plasma (FFP) units exposed to room temperature (24°C) administered as a continuous rate infusion (CRI) for 12 hours.DesignEx vivo study.SettingUniversity teaching hospital and pet blood bank.AnimalsNone.InterventionsNone.Measurements and Main ResultsAn FFP CRI was simulated to replicate the standard routine procedure used in dogs. Plasma samples were collected before starting the CRI (H0), after 4 hours (H4), and after 12 hours (H12). Bacterial culture of FFP was performed and albumin concentration and specific activity levels for factors V, VII, VIII, and IX were measured and compared. All plasma culture results were negative. There were no statistically significant differences at any time point in the factor VIII activity (median 105.5% [range, 75.6%–142.0%] at H0; median 107.8% [range, 75.0%–172.7%] at H4; and median 112.1% [range, 81.7%–171.0%] at H12); factor IX activity (median 119.3% [range, 89.1%–175.9%] at H0; median 123.1% [range, 72.5%–172.7%] at H4; and median 118.3% [range, 86.6%–177.5%] at H12); or albumin concentration (median 21.0 g/L [range, 17.0–23.0 g/L] at H0 and median 20.0 g/L [range, 17.0–24.0 g/L] at H12). A slight but significant increase in factor V activity was observed when comparing H0 (median 107.0% [range, 71.0%–159.0%]) to H4 (median 117.7% [range, 71.0%–176.7%]) (P = 0.002) or H12 (median 116.2% [range, 71.0%–191.6%]) (P = 0.001). A slight but significant increase in factor VII activity was observed when comparing H0 (median 115.4% [range, 70.6%–183.7%]) to H4 (median 118.2% [range, 82.7%–194.6%]) (P = 0.005); H0 to H12 (median 128.7% [range, 86.4%–200.0%]) (P < 0.001); and H4 to H12 (P = 0.002).ConclusionsFFP CRI at room temperature for 12 hours could be considered safe with regard to risk for bacterial growth and also effective by providing albumin and clotting factors.

Using plasma products in small animal practice

“…The transfusion should also be completed within four to six hours of starting so that the risk of bacterial contamination of the unit is reduced. Of interest is a recent ex vivo study which suggests that defrosted plasma can be administered for up to 12 hours without evidence of bacterial growth (Mesa‐Sanchez and others 2023). However, to ensure sterility in potentially immunocompromised sick patients, we recommend adhering to the suggested maximum six‐hour window.…”