plasma protein fraction (Plasmanate, Plasma-Plex, Plasmatein, Protenate)

Introduction

Tradenames: Plasmanate, Plasma-Plex, Plasmatein, Protenate.

Indications

• second line agent for volume expansion & maintenance of cardiac output in shock states resulting from burns, surgery, hemorrhage, trauma, cerebral edema or cirrhosis
• used after crystalloid therapy has failed

Contraindications

pregnancy-category C

safety in lactation ?

Dosage

• 5% solution 250-500 mL IV PRN
• not to exceed 10 mL/min

Injection: 250 & 500 mL vials

Pharmacokinetics

• 1/2life of albumin is 15-19 days with a turnover of 15 g/day
• elimination: liver

Adverse effects

• bleeding due to dilution of clotting factors & decreased platelet aggregation
• fever/chills
• nausea
• hypotension
• allergic reactions (contains bradykinin-like substances & prekallikrein activator)
  • flushing
  • urticaria
  • erythema
  • hypersensitivity
• pulmonary edema
• tachycardia
• headache

Mechanism of action

• human pooled blood fraction
• contributes to colloid oncotic pressure
• shifts fluid from interstitial space to the circulation
• of no benefit in dehydrated patients
• provides no nutritional benefit
• contains 145 meq of Na+ & Cl-
• pH = 7.0

More general terms

• plasma volume expander

Components

• plasma protein