The Constituents of Fresh Frozen Plasma Stored with Citrate Phosphate Dextrose and Their Clinical Implications

Abstract

The authors have investigated the constituents of fresh frozen plasma stored in citrate phosphate dextrose (CPD) at -20 °C. The results indicate abnormal characteristics of several of the constituents, whereas some others remain within normal values. This is attributed to preparation procedures with the addition of a CPD solution. Fresh frozen plasma being hyperosmolal, hypematremic, hyperglycemic, hyperphosphatemic, normokalemic and containing normal values of protein, calcium, magnesium, and water carries a clinical implication for the physician as a guide for the treatment of the critically ill patient when large amounts of plasma are needed.

Modification of Sodium, Glucose, Potassium, and Osmolarity in Packed Red Blood Cells and Fresh Frozen Plasma Using a Desktop Hemoconcentrator Setup

“…Stored packed red blood cells (PRBCs) and fresh frozen plasma (FFP) are associated with electrolytes and glucose that exceed clinically accepted physiologic values (1)(2)(3). PRBCs stored in additive solution or non-additive solutions such as citrate phosphate dextrose (CPD) become hyperkalemic with documented concentrations as high as 50-80 mEq/L (1,2,4,5).…”

“…The published values of sodium, glucose, and calculated osmolarity in PRBCs are 156 mEq/L, 270 mg/%, and 342 mOsm/L on average (4). In FFP with CPD, the sodium, glucose, and osmolarity are 167.5 mEq/L, 308.6 mg/%, and 367.14 mOsm/L on average (3). With the need for rapid or massive transfusion of PRBCs, the literature describes the processing of PRBCs using cell salvage equipment to reduce potassium, glucose, and plasma free hemoglobin levels (PFH) (17)(18)(19).…”