Indications for FFP include

Ans. d (All of the above) (Ref. Harrison 18th/ ch. 113; Table 113-2)Characteristics of Selected Blood ComponentsComponentVolume, mLContentClinical ResponsePRBC180-200RBCs with variable leukocyte content and small amount of plasmaIncrease hemoglobin 10 g/L and hematocrit 3%Platelets50-70200-4005.5 x 1010/RD unit3 x 10U/SDAP productIncrease platelet count 5000-10,000/L CCI 10 x 109/L within 1 h and 7.5 x 109/L within 24 h posttransfusion.FFP200-250Plasma proteins-coagulation factors, proteins C and S, antithrombinIncreases coagulation factors about 2%Cryoprecipitate10-15Cold-insoluble plasma proteins, fibrinogen, factor VIII, vWFTopical fibrin glue, also 80 IU factor VIIIBLOOD COMPONENTSWHOLE BLOOD# It is the ideal component for patients who have sustained acute hemorrhage of =25% total blood volume loss.# Whole blood is stored at 4degC to maintain erythrocyte viability, but platelet dysfunction and degradation of some coagulation factors occurs.# In addition, 2,3-bisphosphoglycerate levels fall over time, leading to an increase in the oxygen affinity of the hemoglobin and a decreased capacity to deliver oxygen to the tissues, a problem with all red cell storage.PACKED RED BLOOD CELLS# It increases oxygen-carrying capacity in the anemic patient.# Adequate oxygenation can be maintained with a hemoglobin content of 70 g/L in the normovolemic patient without cardiac disease; however, comorbid factors often necessitate transfusion at a higher threshold.# In most patients requiring transfusion, levels of hemoglobin of 100 g/L are sufficient to keep oxygen supply from being critically low.# PRBCs may be modified to prevent certain adverse reactions. Leukocyte reduction of cellular blood products is increasingly common, and universal prestorage leukocyte reduction has been recommended.# These PRBC units contain <5 x 106 donor white blood cells (WBCs), and their use lowers the incidence of posttransfusion fever, CMV infections, and alloimmunization.# Other theoretical benefits include less immunosuppression in the recipient and lower risk of infections.# Plasma, which may cause allergic reactions, can be removed from cellular blood components by washing.FRESH-FROZEN PLASMA (FFP)FFP contains stable coagulation factors and plasma proteins:# Fibrinogen,# Antithrombin,# Albumin, as well as# Proteins C and S.Indications for FFP include:# Correction of coagulopathies, including the rapid reversal of warfarin;# Supplying deficient plasma proteins; and# TTP# FFP is an acellular component and does not transmit intracellular infections, e.g., CMV.# Patients who are IgA-deficient and require plasma support should receive FFP from IgA-deficient donors to prevent anaphylaxis.CRYOPRECIPITATE# Cryoprecipitate is a source of fibrinogen, factor VIII, and von Willebrand factor (vWF).# It is ideal for supplying fibrinogen to the volume-sensitive patient.# When factor VIII concentrates are not available cyroprecipitate may be used since each unit contains approximately 80 units of factor VIII.# Cryoprecipitate may also supply vWF to patients with dysfunctional (type II) or absent (type III) von Willebrand disease.# *****FACTOR EX IS ABSENT IN CRYOPRECIPITATE.