Plasma protein fractions

Fig. 6. Share of U.S. market occupied by human albumin/plasma protein fraction, (—) Factor VIII concentrate, (-) intravenous immunoglobulin...

Table 9. Properties of Human Albumin and Plasma Protein Fraction ...

Characteristic Human albumin Plasma protein fraction ... 

The composition of body fluids remains relatively constant despite the many demands placed on the body each day. On occasion, these demands cannot be met, and electrolytes and fluids must be given in an attempt to restore equilibrium. The solutions used in the management of body fluids discussed in this chapter include blood plasma, plasma protein fractions, protein substrates, energy substrates, plasma proteins, electrolytes, and miscellaneous replacement fluids. Electrolytes are electrically charged particles (ions) that are essential for normal cell function and are involved in various metabolic activities. This chapter discusses the use of electrolytes to replace one or more electrolytes that may be lost by the body. The last section of this chapter gives a brief overview of total parenteral nutrition (TPN). 

Plasma protein fractions include human plasma protein fraction 5% and normal serum albumin 5% (Albuminar-5, Buminate 5%) and 25% (Albuminar-25, Buminate 25%). Plasma protein fraction 5% is an IV solution containing 5% human plasma proteins. Serum albumin is obtained from donated whole blood and is a protein found in plasma The albumin fraction of human blood acts to maintain plasma colloid osmotic pressure and as a carrier of intermediate metabolites in the transport and exchange of tissue products. It is critical in regulating the volume of circulating blood. When blood is lost from shock, such as in hemorrhage, there is a reduced plasma volume. When blood volume is reduced, albumin quickly restores the volume in most situations. 

Plasma protein fractions are used to treat hypovolemic (low blood volume) shock that occurs as the result of bums, trauma, surgery, and infections, or in conditions where shock is not currently present but likely to occur. Plasma protein fractions are also used to treat hypoproteinemia (a deficiency of protein in the blood), as might be seen in patients with nephrotic syndrome and hepatic cirrhosis, as well as other diseases or disorders. As with human pooled plasma, blood type and crossmatch is not needed when plasma protein fractions are given. 

Adverse reactions are rare when plasma protein fractions are administered, but nausea, chills, fever, urticaria, and hypotensive episodes may occasionally be seen. 

Plasma proteins are contraindicated in those with a history of allergic reactions to albumin, severe anemia, or cardiac failure in the presence of normal or increased intravascular volume and in patients on cardiopulmonary bypass. Plasma protein fractions are used cautiously in patients who are in shock or dehydrated and in those with congestive cardiac failure or hepatic or renal failure. These solutions are Pregnancy Category C drugp and are used cautiously during pregnancy and lactation. 

Most IV solutions should not be combined with any other solutions or drug s but should be administered alone The nurse should consult the drug insert or other appropriate sources before combining any drug with any plasma protein fraction. 

Solutions used to manage body fluids are often administered IV. Before administering an IV solution, the nurse assesses the patient s general status, reviews recent laboratory test results (when appropriate), weighs the patient (when appropriate), and takes the vital signs. Blood pressure, pulse, and respiratory rate provide a baseline, which is especially important when the patient is receiving blood plasma, plasma expanders, or plasma protein fractions for shock or other serious disorders. 

CBC, complete blood cell count EEG, electroencephalogram NSAIDs, nonsteroidal antiinflammatory drugs O2, oxygen PPF, plasma protein fraction PT, prothrombin time TIPS, transjugular intrahepatic portosystemic shunt. 

Iso-oncotic colloid solutions (plasma and plasma protein fractions), such as 5% albumin and 6% hetastarch, offer the advantage of more rapid restoration of intravascular volume with less volume infused, but there is no significant clinical outcome differences compared with crystalloids. 

Virtually all the mercury in plasma is protein-bound [17, 18]. Haemolyzed samples of blood from rats given radioactive mercuric chloride yielded less than 0.5% ultrafiltrate mercury. The distribution between different plasma-protein fractions varied with dose, time after, and type of, administration [19-21]. 

In healthy men total plasma proteins were observed to rise an average of 0.53 g/100 ml and albumin 0.42 g/100 ml in specimens drawn 15-30 minutes after arising in the morning, as compared to the concentrations in specimens obtained just before arising (AlO). The rise was of the same proportion in each of the plasma protein fractions, and therefore the percentage distribution of the fractions did not change. In another study, increases of as much as 0.75 g/lOO ml in total protein were observed in active upright persons as compared to the concentration in a specimen from the subject when he was recumbent and at rest (W6). 

Plasma, plasma protein fractions, whole blood or plasma expanders may be required. 

Hetastarch (Hespan) Plasma Protein Fraction (Plasmanate)... 

Plasma Protein Fraction (Plasmanate, Others) [Plasma Volume Expander] Uses Shock 4- BP Action Plasma volume expander Dose Adults. Initial, 250-500 mL IV (not >10 mL/min) subsequent inf... 

Table 9.3. Some colloidal plasma volume expanders currently in therapeutic use. In addition to these, albumin and plasma protein fraction may also be used...

Cry precipitate is a plasma protein fraction obtainable from whole blood. It is used to treat deficiencies or qualitative abnormalities of fibrinogen, such as that which occurs with disseminated intravascular coagulation and liver disease. A single unit of cryoprecipitate contains 300 mg of fibrinogen. 

Brummelhuis HGJ (1980) Preparation of the Prothrombin complex. In Curling JM (ed) Methods of plasma protein fractionation. Academic Press, New York, p 117... 

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