Plasma, the pale yellow, liquid component of blood, comprises over half of its total volume, typically around 55%. This fluid primarily consists of water (about 92%), but it also carries a complex mixture of dissolved constituents, including proteins like albumin, fibrinogen, and globulins, along with electrolytes, hormones, nutrients, and waste products. Plasma serves as a transport medium, delivering essential substances to cells throughout the body and removing metabolic waste products for excretion. Its comprehensive composition allows it to maintain osmotic pressure, regulate blood pressure, distribute heat, and play a role in the body’s acid-base balance.
Addressing Acute Blood Loss and Coagulation Issues
Plasma is frequently administered in emergency situations characterized by significant blood loss or severe problems with blood clotting. In trauma patients, for instance, fresh frozen plasma (FFP) is used to replace lost blood volume and provide essential clotting factors that help stop bleeding. Studies suggest that higher ratios of FFP to packed red blood cells during massive transfusions in trauma cases are associated with improved survival. This intervention is crucial for stabilizing patients, especially those experiencing hypovolemic shock, by restoring fluid volume and maintaining blood pressure.
Severe burn injuries also necessitate plasma treatment due to substantial fluid loss and potential compromise of the body’s clotting system. Plasma transfusions help replenish fluid volume, prevent burn shock, and supply clotting factors to address any coagulation issues.
Patients with liver disease often experience impaired synthesis of clotting factors, leading to a higher risk of bleeding. Plasma transfusions can provide these missing coagulation factors, improving the patient’s clotting profile and helping to prevent or manage bleeding complications. Plasma exchange, a procedure that removes and replaces a patient’s plasma, can also support liver function by eliminating accumulated toxins and restoring coagulation factors, serving as a bridge to liver transplantation. Additionally, plasma is used to reverse the effects of certain anticoagulant medications, which can be critical in situations where rapid normalization of blood clotting is required.
Supporting Immune System Function
Plasma contains antibodies, also known as immunoglobulins, which are proteins that play a central role in the body’s immune defense against infections. These antibodies are extracted from donated plasma to create specialized treatments, such as Intravenous Immunoglobulin (IVIG). IVIG therapy is a standard treatment for individuals with primary immunodeficiencies, conditions where the body cannot produce enough of its own antibodies to fight off infections. It provides a broad spectrum of antibodies, helping to strengthen the immune system and reduce the frequency and severity of infections.
IVIG is also used in certain autoimmune conditions, where the immune system mistakenly attacks the body’s own tissues. In these cases, high doses of IVIG can modulate the immune response, helping to alleviate symptoms and prevent further damage. For example, in Myasthenia Gravis, IVIG helps by interfering with the autoimmune attack on nerve-muscle junctions.
Targeting Other Specific Medical Needs
Beyond acute blood loss and immune support, plasma and its derivatives have several other medical applications. Albumin, a protein abundant in plasma, is used to maintain blood volume and pressure in patients experiencing shock, severe burns, or certain kidney and liver conditions. Albumin helps prevent fluid from leaking out of blood vessels, ensuring that blood circulates effectively throughout the body.
Therapeutic plasma exchange, also known as plasmapheresis, is a procedure where a patient’s plasma is removed and replaced with donor plasma or a substitute solution. This treatment is employed for specific autoimmune and neurological disorders by removing harmful antibodies or other substances from the patient’s blood. Conditions such as Guillain-Barré Syndrome, Myasthenia Gravis, and Thrombotic Thrombocytopenic Purpura (TTP) often benefit from plasmapheresis.
Plasma also serves as a source for factor concentrates used in treating specific bleeding disorders. Plasma-derived factor concentrates remain an option for conditions like hemophilia, which involves a deficiency in particular clotting factors. These concentrates provide the missing factors necessary for proper blood clotting.