Throughout the past decades, increasing concern has been raised regarding the risks of synthetic colloid administration in critically ill patients. The alternative use of human albumin concentrate has been associated with life-threatening hypersensitivity reactions. Constant rate infusion (CRI) of plasma derivatives has been suggested as a viable substitute. Furthermore, the use of plasma CRI could mitigate bleeding or attenuate vascular permeability, edema and inflammation in patients with coagulopathy or systemic inflammatory response syndrome, respectively. Plasma CRI is being used in veterinary medicine, despite the uncertainty of plasma proteins stability during prolonged CRI administration at room temperature, and the potential risk of bacterial contamination/overgrowth. The objectives of this study were to assess the albumin concentration and activity of coagulation factors V, VII, VIII and IX, and to determine the risk of bacterial overgrowth during a 12-h plasma CRI.

Twenty canine fresh frozen plasma units (mean storage time of 6 months, SD±2) were thawed using a water bath at 35°C for 20 minutes. An infusion system was connected to the plasma bag on one end and to a 22-G catheter on the other. Simulating the skin of a patient, the catheter was connected to an empty collecting bag through a rubber pinch device. These procedures were performed under regular veterinary hospital sterility conditions. A second rubber pinch device was attached to the empty bag to collect samples for analysis. A CRI was simulated during 12 h at 24°C. Samples were collected at the beginning of the CRI (T0), after 4 h (T1), and after 12 h (T2). Plasma culture was performed and specific clotting times for factors V, VII, VIII and IX were measured at the three time points. Albumin levels were assessed at T0 and T2.

All culture results were negative. There was no significant difference between the activity for factors VIII (106.55±18.59% at T0, 109.93±22.58% at T1 and 115.46±23.73% at T2) and IX (122.33±22.84% at T0, 125.29±26.07% at T1 and 120.99±22.59% at T2) and for albumin levels (2.05±0.15g/dl at T0 vs 2.06±0.18g/dl at T2) at any time point. A slight but significant increase in factor V activity was observed when comparing T0 (108.92±27.14%) to T1 (121.97±27.31% p=0.002) or T2 (123.26±31.63% p=0.001), and for factor VII when comparing T0 (117.34±31.95%) to T1 (125.63±33.01% p=0.005), and T1 to T2 (134.70±32.51% p=0.002).

We may conclude that plasma CRI at room temperature during 12 h is safe regarding bacterial growth, and effectively provides albumin and clotting factors.

Disclosures

No disclosures to report.