Fresh frozen plasma (FFP) is made from plasma, the clear part of the blood, which is separated out of donated blood in the process of making concentrated red blood cells for transfusions. It is treated with certain chemicals to neutralize any viruses or other pathogens that the donor might have had in their blood, then frozen at minus 35 C (minus 31 F) to keep it fresh.
How FFP can help angioedema patients
C1-INH blocks two other proteins, plasma kallikrein, and coagulation factor 12, from producing a different substance called bradykinin. Bradykinin regulates blood pressure and inflammation by encouraging small blood vessels to dilate or widen.
Angioedema swelling occurs when bradykinin is activated in the deep layers of the skin and allows fluid to flow into the tissues of the skin from the bloodstream. So, by quickly replacing C1-INH using FFP, bradykinin production can be reduced greatly. The faster bradykinin levels fall to normal levels, the sooner the swellings can be reduced to a safer level.
FFP as an alternative to other treatments
Many sudden angioedema swellings can be treated with allergy medicines, such as antihistamines, corticosteroids, and epinephrine (as in an EpiPen). However, these will not be effective in the case of non-allergic angioedema.
In such cases, other medications can be used, including Firazyr (icatibant), which can be used in much the same way as an EpiPen for immediate, self-treatment. C1-INH boosting medicines such as Haegarda, Cinryze, and Kalbitor can be used both to prevent attacks and to bring down life-threatening swelling.
These may not always be present and available in an emergency room. However, FFP is.
Use of FFP in the emergency room
Angioedema swellings can become life-threatening if they occur in the mouth and throat and block the airways. In such situations, patients will require emergency treatment.
FFP may be used as a life-saving technique in emergency rooms to immediately treat cases of life-threatening angioedema that do not respond to other treatments.
Case studies, including a series of compared case studies by the New York Medical College, showed that FFP can be used in emergency rooms for severe and life-threatening swelling. It also may reduce the need for more invasive procedures to restore breathing.
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