A cirrhotic patient with abnormal coagulation studies due to hepatic synthetic dysfunction requires an urgent cholecystectomy. A transfusion of FFP is planned to minimize the risk of bleeding due to surgery. What is the optimal timing of this transfusion?
Transfusions with FFP to replenish vitamin K-dependent clotting factors should be administered on call to the operating room. The timing of transfusion is dependent on the quantity of each factor delivered and its half-life. The half-life of the most stable clotting factor, factor VII, is 4 to 6 hours. Thus, transfusion of FFP on call to the operating room ensures that the transfusion is complete prior to the incision, with circulating factors to cover the operative and immediate postoperative period.
The day before surgery
The night before surgery
On call to surgery
Intraoperatively
Preoperative assessment and monitoring in anaesthesia