Canine Plasma

Manufacturer: Animal Blood Resources International

Ca Vet. Biol. Lic. No.

83

Active Ingredient(s)

Each 10 mL CPDA-1 contains:

Dextrose (hydrous)	317 mg USP
Sodium citrate (hydrous)	263 mg USP
Citric acid (hydrous)	33 mg USP
Monobasic sodium phosphate (monohydrate)	22 mg USP
Adenine	2.7 mg USP
Water	q.s. USP

Table of Product Contents:

	Whole Blood	RBC’s	Plasma	CPDA-1	Total Fluid Volume	Range
Fresh Frozen (1 unit)	-0-	-0-	approx. 100 mL	approx. 20 mL	approx. 120 mL	105-140 mL
Frozen (1 unit)	-0-	-0-	approx. 100 mL	approx. 20 mL	approx. 120 mL & 50 mL mini-unit	105-140 mL

CANINE PLASMA, Fresh Frozen is a transfusion product aseptically obtained from healthy dogs maintained in an isolated, controlled access colony. Blood is not pooled (ie. each unit of blood is from a single-donor) and euthanasia donors are never used. All colony donors are serologically negative for Canine brucellosis, Ehrlichia canis, Borrelia burgdorferi (Lyme Disease), and Dirofilaria immitis. The blood type of each donor dog is indicated on the product label. The colony receives intensive onsite veterinary health care, and all animals are current on immunizations, to include: Canine distemper, hepatitis, leptospirosis, parainfluenza, canine parvovirus, and rabies.

The anticoagulant CPDA-1 is present. It consists of citrate, phosphate, dextrose, and adenine.

A unit of CANINE PLASMA, Fresh Frozen is prepared via the centrifugation of canine whole blood, and is produced within six hours of the time of collection of the original whole blood from the donor dog; has a total fluid volume of approximately 120 mL; and a shelf-life of one year.

A unit of CANINE PLASMA, Frozen is distinguished from the fresh frozen plasma in that it may be prepared at any time up to five days after the expiration date applicable to the original unit of whole blood. Clinically, this difference results in reduced amounts of some coagulation factors in the older product, as well as slightly increased levels of potassium and ammonia; however, such plasma is a viable source of the other components of plasma such as albumin, globulins, and electrolytes, as well as replacement fluid volume. A unit of CANINE PLASMA, Frozen has a total fluid volume of approximately 120 mL; and a shelf-life of five years. 50 mL mini-units are also available.

Canine Plasma Indications

CANINE PLASMA, Fresh Frozen when properly thawed, is indicated for parenteral replenishment of coagulation factors, albumin, globulins, electrolytes, and fluid volume, as indicated by the clinician's/internist's evaluation of the patient.

CANINE PLASMA, Frozen when properly thawed, is indicated for parenteral replenishment of albumin, globulins, electrolytes, and fluid volume.

Canine Plasma Dosage And Administration

Blood Filter: A blood filter should always be used when administering plasma. When administering over 50 mL of blood to a patient, use the standard blood administration set with its integral 170-230 micron clot screen filter. When administering less than 50 mL of blood to a patient, the standard blood administration set's filter (with a relatively huge surface area) will trap too much blood. Therefore, when transfusing less than 50 mL of blood, the following configuration is recommended:

1. Remove one (1) red cap (white on some models) from the blood bag's diaphragm port, and insert the spike of the drip chamber end of a Venoset 70 Microdrip set into the now uncovered blood bag diaphragm port. The second red cap, found on whole blood bags and red blood cell bags, should remain in place. Technically, non-vented fluid administration sets are safer than using blood bags. This can be simulated by aseptically replacing the Venoset's air filter with the male end of a 3 mL syringe, with its plunger in place. Never leave the Venoset's air filter port uncovered.

2. Attach the needle adaptor end of the Venoset into the female end of a Hemo-Nate neonatal filter, model #HN-179.

3. Then attach the male end of the filter to the female end of a 30 inch IV extension set.

4. Finally, attach the male end of the extension set to an IV catheter pre-positioned in the patient.

With the above technique, transfusion can be obtained via a slow continuous drip over several hours (or longer), therefore minimizing volume overload.

5. If the bolus technique is preferred, simply aspirate the blood into a sterile syringe, then aseptically place the Hemo-Nate filter between the syringe and a fresh sterile needle/catheter, before transfusing.

Plasma bags can readily be adapted for syringe access via Gesco international's Hemo-Tap device, model #HT-180 (2 1/2 inches long, with a spike at one end and a brown hypodermic needle port at the other end).

Route of Administration: The jugular, cephalic, and saphenous veins are common sites for IV catheter placement. The intramedullary cavity of the femur and humerus are alternate sites. Additionally, intraperitoneal transfusions have application in selected patients.

Rate of Infusion:

1. There is virtually no rate of blood infusion that is safe for all canine patients; therefore the following are only general guidelines. The actual rate of infusion of blood must be tailored to each individual patient.

2. If clinical conditions permit, the initial rate should be slow (about 0.11 mL/lb. BW over a 30-minute period), in order to observe the patient for transfusion reactions.

(0.11 mL/lb. = @ 0.25 mL/kg).

3. If plasma is being administered for hypoproteinemia, a suggested dose is 6 to 10 mL/kg BW (@ 2.7 to 4.5 mL/lb. BW).

Post-Transfusion Patient Care: During and after transfusions, the patient should be closely monitored. In addition to physical examinations and temperature monitoring, measurement of PCV, urine output, body weight, and EKG are recommended. Measurement of CVP may be utilized in some cases. In all cases, infusion rates should be calculated (rather than estimated) and closely monitored.

Contraindication(s)

The plasma was frozen in a horizontal position then stored upright. If the frozen plasma bag shows cracks or signs of premature thawing and refreezing (ie. thicker at the bottom than at the top) do not administer.

Do not administer (via the same infusion system) in conjunction with other fluids or drugs, except 0.9% NaCl.

Do not administer to species other than the domestic dog.

Precaution(s)

1. Frozen plasma bags must be carefully handled to avoid cracking the plastic bags and to avoid contamination during thawing. Thawing should be conducted at 86 to 98.6°F (30 to 37°C). Do not exceed 98.6°F at any time. The use of a controlled temperature circulating warm water bath is the preferred thawing method. (Although some clinicians advocate the use of a microwave for thawing frozen plasma, the potential for hot spots prevents the recommendation of this latter technique).

2. Always conduct a minor crossmatch before transfusing plasma.

3. Infusion of plasma should begin within six hours of thawing. Do not re-freeze plasma once it has been thawed.

These units have a shelf-life of one year for Fresh Frozen Plasma and five years for Frozen Plasma from the date of collection of the original unit of whole blood. They should be maintained in a freezer at below 0°F. (chest type freezers work best). Store the frozen plasma bags in a vertical position (to detect thawing, as they were originally frozen in an horizontal position). Caution, the defrost cycle on some freezers allows the temperature to briefly rise above zero. This can be partially compensated for by sandwiching plasma bags between bags of deep frozen artificial ice. (This technique will only work if the artificial ice has been pre-frozen to a temperature of below 0°F).

A method of monitoring freezer and refrigerator temperatures is to install an indoor/outdoor thermometer on the freezer, such that the sensor is inside the freezer, yet the gauge is mounted on its casing so that the temperature can be easily read without opening the door or lid.

It is recommended that one of the hospital technicians view and record, at least twice a day, the internal temperature of the plasma freezer.

Canine Plasma Caution(s)

1. During transfusions, fluid flow rates must be carefully calculated and monitored, based on the patient's size, weight, age, and clinical condition. It is recommended that urine output be monitored as well.

2. Gently oscillate each bag before use in order to mix contents.

3. Use gloves when handling the dry ice, which is used when shipping frozen plasma.

4. Do not allow dry ice to contact bare skin.

5. Complications of transfusions are manifest by a variety of clinical signs including jaundice, fever, cardiac arrythmias, erratic respiration, salivation, hemoglobinuria, edema, DIC, hemorrhage, vomiting, and urticaria. If any of these clinical signs develop, immediately stop the transfusion and institute appropriate supportive measures, as determined by the patient's clinical condition and the clinician's medical judgment.

6. For use in domestic dogs only.

Warning(s)

1. Circulatory overload can occur quickly unless all patient parameters are closely monitored.

2. Do not add medications to the blood bags nor via the same infusion system.

3. In spite of serological screening, disease organisms may still be present in these transfusion products.

4. Platelets are not viable in these products.

5. Do not administer any of these blood products without a blood filter.

6. Do not add Lactated Ringer's solution to whole blood or to red blood cells. It is safest to use 0.9% NaCl as the only fluid/drug administered in conjunction with these blood products.

7. Transfusion reactions can still occur in spite of correct blood typing and proper crossmatching.

References

Available upon request.

Presentation

Units of CANINE PLASMA, Fresh Frozen and Frozen are supplied frozen (packed in dry ice), in blood grade plastic bags (with one IV set coupling port, and reference aliquots [tubing segments]).

Nac No.

13980001