Prophylaxis and Treatment of Hereditary Angioedema with Fresh Frozen Plasma: A Synthesis and Narrative Review

Authors

  • Meredith Mosier, RN, BSN, RRNA Texas Christian University
  • J. Dru Riddle, PhD, DNP, CRNA Texas Christian University

DOI:

https://doi.org/10.18776/ppxqh407

Keywords:

angioedema, fresh frozen plasma, surgery

Abstract

Patients with angioedema who experience an acute exacerbation may die if their symptoms are not treated promptly. Airway compromise can occur if proper precautions are not taken. Surgical patients with hereditary angioedema should undergo prophylactic treatment before surgical procedures to decrease the risk of an exacerbation. A literature search was performed using the Embase (Elsevier), CINAHL (EBSCO), Health Source: Nursing/Academic Edition (EBSCO), and MEDLINE (National Library of Medicine) databases. Six articles were found that discussed administration of fresh fro-zen plasma (FFP) for treatment or prophylaxis against angioedema exacerbations. Synthesis of the evidence suggests that use of FFP as a sole prophylaxis or treatment for angioedema is inappropriate. FFP can be used as part of a multimodal treatment plan for prophylaxis against angioedema if a C1 esterase inhibitor is not available. 

Author Biographies

  • Meredith Mosier, RN, BSN, RRNA, Texas Christian University

    School of Nurse Anesthesia Texas Christian University, Fort Worth, TX. The author was a student at the time of writing.

  • J. Dru Riddle, PhD, DNP, CRNA, Texas Christian University

    Assistant Professor of Professional Practice, School of Nurse Anesthesia Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, TX

References

MacBeth LS, Volcheck GW, Sprung J, Weingarten TN. Preoperative course in patients with hereditary or acquired angioedema. J Clin Anesth. 2016;34:385-391. doi:10.1016/j.jclinane. 2016.05.010.

Levy JH, Freiberger DJ, Roback J. Hereditary angioedema: Current and emerging treatment options. Anesth Analg. 2010;110(5):1271-1280. doi:10.1213/ANE.0b013e3181d7ac98.

Szema AM, Paz G, Merriam L, Stellaccio F, Jen J. Modern preoperative and intraoperative management of hereditary angioedema. Allergy Asthma Proc. 2009;30:338–342. doi:10.2500/aap.2009.30.3225.

Mihailovic S, Volas L, Arezina Mihailovic A. Hereditary angioedema type II: perioperative management of coronary artery bypass graft surgery: 4AP2‐2. Eur J Anaesthesiol. 2012;29:55.

Prematta M, Gibbs JG, Pratt EL, Stoughton TR Craig TJ. Fresh frozen plasma for the treatment of hereditary angioedema. Ann Allergy Asthma Immunol. 2007;98:383-388. doi:10.1016/S1081-1206(10)60886-1.

Shick V, Sanchala V, McGoldrick K, Tartaglia JJ, Nelson J, Fleisher AJ. Perioperative management of a patient with hereditary angioedema during off-pump coronary artery bypass graft surgery. J Clin Anesth. 2010;22:282-284. doi:10.1016/j.jclinane.2009.04.007.

Cifuentes J, Palisson F, Valladares S, Jerez D. Life-threatening complications following orthognathic surgery in a patient with undiagnosed hereditary angioedema. J Oral Maxillofac Surg. 2013;71:e185-e188. doi:10.1016/j.joms.2012.11.023.

Levels of Evidence and Grades of Recommendation Working Party. New JBI levels of evidence. The Joanna Briggs Institute Web site. http://joannabriggs.org/assets/docs/approach/ JBI-Levels-of-evidence_2014.pdf. Published October 2013. Accessed April 20, 2016.

Published

2018-06-28

Issue

Section

Articles