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解冻复冻新鲜冰冻血浆的凝血参数及无菌性初步研究

A Preliminary Study on Coagulation Parameters and Sterility of Thawed Refrozen Fresh Frozen Plasma.

作者信息

Draman Rahayu, Yousuf Rabeya, Abdul Aziz Suria, Ding Chuan Hun, Zainol Suzana, Leong Chooi Fun

机构信息

Department of Pathology, Hospital Pekan, Pekan, Pahang Darul Makmur Malaysia.

2Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

出版信息

Indian J Hematol Blood Transfus. 2020 Jan;36(1):112-116. doi: 10.1007/s12288-019-01171-0. Epub 2019 Aug 21.

Abstract

Thawed fresh frozen plasma (FFP) if not used within 6 h, may have to be discarded due to the risk of contamination and uncertainty about its quality. The main objective of this study was to evaluate the levels of coagulation Factor II (FII), Factor VIII (FVIII), fibrinogen and bacterial growth in thawed refrozen FFP. Thirty FFP samples were collected from healthy donors. FFP were thawed in water bath at 37 °C for 20-25 min. Approximately 10 mL of plasma from each FFP unit was tested for FII, FVIII, fibrinogen and sterility. The thawed FFP units were then kept at 4 °C for 6 h before being refrozen and stored at - 20 °C. Two weeks later, the refrozen FFP were thawed again and representative samples were analysed as before. There was a significant decline in the mean FVIII level, from 155.77% to 85.6% at second thaw. The mean FII level increased significantly from 74.9% to 82%, whereas the mean fibrinogen level fell from 3.34g/L to 3.28 g/L, but the decline was not statistically significant. There was no bacterial contamination in all samples at both time points. Refrozen plasma may be considered as an alternative to the storage of thawed unused FFP provided they are kept in a controlled environment to reduce wastage. These thawed refrozen FFP can be used later in bleeding cases like other FFP as the levels of FVIII are still within the standard haematology range (0.5-2 IU/mL) and above the minimal level of 30% coagulation factors required for adequate haemostasis.

摘要

解冻后的新鲜冰冻血浆(FFP)如果在6小时内未使用,由于存在污染风险及其质量的不确定性,可能不得不丢弃。本研究的主要目的是评估解冻后再冷冻的FFP中凝血因子II(FII)、因子VIII(FVIII)、纤维蛋白原水平及细菌生长情况。从健康献血者中采集了30份FFP样本。将FFP在37℃水浴中解冻20 - 25分钟。对每个FFP单位约10mL血浆进行FII、FVIII、纤维蛋白原及无菌检测。然后将解冻后的FFP单位在4℃保存6小时,之后再冷冻并储存在-20℃。两周后,再次解冻再冷冻的FFP,并像之前一样分析代表性样本。第二次解冻时,平均FVIII水平显著下降,从155.77%降至85.6%。平均FII水平从74.9%显著升至82%,而平均纤维蛋白原水平从3.34g/L降至3.28g/L,但下降无统计学意义。两个时间点的所有样本均未发现细菌污染。再冷冻血浆可被视为解冻后未使用的FFP储存的一种替代方法,前提是将它们保存在受控环境中以减少浪费。这些解冻后再冷冻的FFP后来可用于出血病例,如同其他FFP一样,因为FVIII水平仍在标准血液学范围内(0.5 - 2IU/mL)且高于充分止血所需的30%凝血因子的最低水平。

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Why do physicians request fresh frozen plasma?医生为什么要申请新鲜冰冻血浆?
Transfusion. 2004 Sep;44(9):1393-4. doi: 10.1111/j.0041-1132.2004.00422.x.

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