What is a simple definition of plasma?

What is a simple definition of plasma? : The portion of the blood that carries the blood cells is clear and yellowish in color . Plasma contains the proteins that cause blood clots.
What is the medical definition of plasma? : What does -plasm mean? The combining form plasm is used like a suffix meaning living substance , tissue, substance of a cell It is very occasionally used in scientific terms, especially in biology
What are the 4 functions of plasma? : It supports the body’s pH balance, blood volume, blood pressure, immunity, blood clotting, and other physiological processes.

Read Detail Answer On What are the 4 functions of plasma?

Plasma, also known as blood plasma, appears light-yellowish or straw-colored. It serves as the liquid base for whole blood. Whole blood minus erythrocytes (RBCs), leukocytes (WBCs), and thrombocytes (platelets) make up the plasma. Serum, sometimes mistakenly considered synonymous with plasma, consists of plasma without fibrinogen. Plasmacontains 91% to 92% of water and 8% to 9% of solids. It mainly comprises of:

  • Coagulants, mainly fibrinogen, aid in blood clotting   

  • Plasma proteins, such as albumin and globulin, that help maintain the colloidal osmotic pressure at about 25 mmHg

  • Electrolytes like sodium, potassium, bicarbonate, chloride, and calcium help maintain blood pH

  • Immunoglobulins help fight infection and various other small amounts of enzymes,hormones, and vitamins

  • Issues of Concern

    It can be separated from whole blood by the process of centrifugation, i e , spinning whole blood with an anticoagulant in a centrifuge Plasma is lighter, forming the upper yellowish layer while the denser blood cells fall to the bottom The plasma collected is frozen within 24 hours to preserve the functionality of the various clottingfactors and immunoglobulins;itis thawedbefore use andhas a shelf life of 1 year Interestingly, while O- is the preferred universal donor for blood, the plasma of AB blood groups is the most preferred because their plasma does not contain antibodies, making it acceptable for everyone without fear of an adverse reaction

    Plasma, like whole blood, is initially tested to ensure the safety of recipients. As per the FDA regulations, the collected plasma undergoes abattery of tests to identify transmittable diseases, mainly hepatitis A, B, and C, along with syphilis and HIV. The process of fractionation separates individual plasma proteins.[1]

    Cellular

    The specific gravity of plasma is 1.022 to 1.026 compared to the specific gravity of blood which is 1.052 to 1.061. Plasma forms 55%, andred blood cells form 45% of the total blood. Four major products derived from the plasma which can be used are fresh-frozen plasma (FFP), plasma frozen within 24 hours of phlebotomy (FP24), cryoprecipitate-poor plasma (CPP), and thawed plasma. FP24, CPP, and thawed plasma contain varying amounts of clotting factors.[2]

    Development

    Plasma proteins, on the other hand, have distinct organs that produce them based on an individual’s stage of development. In Embryo

    In the embryonic stage, the mesenchymal cells are responsible for plasma cellproduction The first protein to be synthesized is albumin, followed by globulin and the other plasma proteins

    In Adults

    The reticuloendothelial cells of the liver are in charge of plasma protein synthesis in adults. The bone marrow, degeneratingblood cells, general body tissue cells, and the spleen also contribute to the formation of plasma proteins. Gamma globulins originate from B lymphocytes, which in turn form immunoglobulins.

    Organ Systems Involved

    The origin of plasma, which constitutes 55% of total blood, is interesting because no organ produces it. Instead, it is formed from water and salts absorbed through the digestive tract. 

    Function

    Water constitutes about two-thirds of the human body. In an adult man weighing 70 kg, the body water content is about 42L. This water content is divided into two major compartments:

    • Intracellular fluid (ICF): It forms about 28 L (about 40% of total body weight)

    • Extracellular fluid (ECF): It forms about 14 L (about 20% of total body weight), of which 15% is interstitialfluid and 5% is plasma

    Plasma can be measured using marker substances like radioactive iodine (131 I) and Evans blue (T-1824). Evans blue is the commonly used marker substance (aka tracer) since it binds strongly with albumin. The concept behind using a tracer is to use one that is well distributed in the compartment of interest. A known amount of tracer is introduced into the compartment, and its volume of distribution is measured. [4]

    • Volume = Amount of Tracer/Concentration of Tracer

    Compartment volumes are measured based on the volume of distribution of tracer. When measuring plasma volume, the albumin-bound tracer, i.e., Evans blue, is used. As albumin tends to continuously leak out of the circulation, the tracer concentration is measured at serial intervals and is plotted on alogarithmic curve. This curve is then extrapolated to identify a “zero time” that allows the estimation of a virtual volume of distribution. The volume of distribution measured is the volume of plasma. 

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    Pathophysiology

    There are many disease processes associated with plasma:

  • Thrombotic thrombocytopenic purpura (TTP): a type of microangiopathic hemolytic anemia that manifests as fever,thrombocytopenia, hemolytic anemia, renal dysfunction, and neurologic dysfunction. All five criteria might not be present in all patients. It is often due to the deficiency or inhibition of ADAMTS13, a metalloproteinase that breaks apart big von Willebrand factor (vWF) multimers. In TTP, these large vWF multimers are not broken down and cause increased platelet adhesion and thrombosis. Labs will often show anemia, thrombocytopenia, schistocytes on peripheral smear, increased LDH, increasedcreatinine, and increased bleeding time with normal PT and PTT. Treatment most involves plasma exchange with fresh frozen plasma, steroids, and splenectomy. Platelets should not be given since it causes more thrombosis. Plasma exchange allows for a good prognosis in patients with TTP.[5]

  • Clotting disorders: Deficiency of specific clotting factors cause hemophilia. Hemophilia Ais due to factor VIII deficiency, while hemophilia B is due to deficiency of factor IX. Symptoms involve hemarthrosis and intramuscular hematomas. Prophylactic transfusion of a factor VIII- or factor IX-concentrate is the main treatment for children with severe hemophilia; however, this leads over time to the formation of antibodies against these factors.[6]

  • Von Willebranddisease: It is due to a deficiency or abnormal von Willebrand factor (vWF), which is the most common bleeding disorder and is an autosomal dominant disorder. vWF is needed to protect factor VIII, which is critical for secondary hemostasis. The main role of vWF is to allow for platelet-subendothelium interaction and platelet-to-platelet aggregation. The amount of bleeding seen in patients is directly correlated to the severity of deficiency of vWF and factor VIII. Bleeding from mucocutaneoussurfaces (gingiva, menstrual bleeding, easy bruising) are commonly seen. Since factor VIII is only mildly reduced, symptoms such as intramuscular hematomas or hemarthrosis are rare. In terms of lab abnormalities, the platelet count is normal, and bleeding time is increased, prothrombin time (PT) is normal, activated partial thromboplastin time (APTT) may increase (depending on the deficiency of Factor VIII). The VWF-ristocetin cofactor activity assay is used for diagnosis. The VonWillebrand ristocetin cofactor assay tests the ability of a plasma sample to agglutinate platelets in the presence of the Ristocetin. The rate of ristocetin-induced agglutination is directly proportional to the amount and activity of the von Willebrand factor.[7]

  • Immunodeficiency: Antibodies or immunoglobulins play a critical role in the immune system to fight off infections.There are 5 classes of immunoglobulins which are IgM, IgG, IgA, IgD, and IgE. The deficiency of each of them can present with unique symptoms. Failure to produce any immunoglobulins occurs in X-linked agammaglobulinemia (Bruton disease), which is due to the failure of pre-B cells to become mature B cells. IgA deficiency is the major mucosal antibody that causes diarrhea and respiratory infections if it is deficient. Hyper IgM syndrome occurs when the inability of CD40 to interactwith B cell causes IgM levels to remain high because of the inability to change into other antibody types.[8] 

  • Clinical Significance

    The numerous clinical uses of plasma can be best explained when considering the various forms and components of blood plasma:[9]

  • Whole Plasma: Fresh frozen plasma is indicated in the treatment of massive bleeds resulting in shock, in disseminated intravascular coagulation, burns, and liver disease—the coagulants found in plasma aid in decreasing bleeding time and stabilizes the patient. Fresh frozen plasma also plays an important role as an immediate and effective antidote for warfarin reversal. Thefirst-line treatment of thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS) is plasma exchange with 40 mL of plasma per kg body weight. In neonates, plasma plays a role in the exchange transfusion of plasma of neonates with severe hemolysis or hyperbilirubinemia. Plasma is also utilized in filling the oxygenator in extracorporeal membrane oxygenation in neonates.

  • Clotting factors: Clotting factors and von Willebrand factor (vWF) found inplasma play an essential role in blood clotting and are activated by damage to the endothelium resulting in exposure of collagen found beneath the endothelium of the blood vessel. People with blood clotting deficiencies such as hemophilia and von Willebrand disease can suffer massive internal bleeds with a minor injury. Such patients benefit greatly from plasma protein derivatives such as factor VIII concentrate and factor IX concentrate.

  • Immunoglobulins: Immunoglobulinsprotect the body against invading bacteria and viruses and play a key role in the body’s defense. Certain immunological disorders like congenital or acquired primary immune deficiency occur when the body cannot produce antibodies or experience the adverse effects of cancer treatments that harm the antibodies. Both disorders benefit greatly from immunoglobulin infusions. Immunoglobulins also play a major role in passive immunization. Antidotes to diseases such as chickenpox, rabies,hepatitis, and tetanus are the initial treatment after suspected exposure to limit disease progression. Such specific immunoglobulins are derived when patients who have been previously affected by a disease donate plasma, for example, chickenpox. This plasma contains high amounts of circulating antibodies against chickenpox that can be collected and stored after fractionation for use as post-exposure vaccines for varicella.

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  • Albumin: Albumin is the main protein thatcontrols oncotic pressure and serves as the transporter of multiple endogenous and exogenous substances (e.g., drugs) throughout the body. Infusion of albumin is used in the treatment of burns and hemorrhagic shock. Studies have also shown marked improvement in the prognosis of cirrhotic patients.[10] In patients with liver cirrhosis, albumin infusions have decreased mortality in patients withspontaneous bacterial peritonitis and improved outcomes in large volume paracentesis.[11][12] Albumin is also useful in the management of hepatorenal syndrome.

  • Alpha-1 antitrypsin: Alpha-1 antitrypsin is produced in the liver and plays an important role in the lungs byincreasing proteases which counteract the effect of elastases produced by the neutrophils in response to inflammation such as smoking. Alpha-1 antitrypsin deficiency is an inherited disorder that could result in emphysema and cirrhosis in early adulthood. Recent advances in treatment have shown success in decreasing the mortality and frequency of exacerbations when human plasma-derived alpha-1 antitrypsin is given intravenously once aweek.[13][14]

  • Plasma as a laboratory test: Plasma testing can diagnose and confirm diseases like diabetes based on serum glucose levels or von Willebrand disease. Monitoring of international normalized ratio (INR) in patients on anticoagulants requires serial measurements ofplasma prothrombin levels.[15]

  • Plasmapheresis: Plasmapheresis is an effective temporary treatment in many autoimmune diseases. In therapeutic plasmapheresis, the patient’s venous blood is withdrawn, blood cells are separated, and a replacement colloid solution and blood cells are infused in itsplace.[16] A 4% to 5% human serum albumin solution in saline is the preferred replacement solution in most cases. The following are common conditions where plasmapheresis is utilized:

    • Myasthenia gravis

    • Chronic inflammatory demyelinating polyneuropathy

    • Hyperviscosity in monoclonal gammopathies

    • Thrombotic thrombocytopenic purpura

    • Guillain-Barre syndrome

    • Lambert-Eaton syndrome

    • Multiple sclerosis

         8. Platelet-rich Plasma (PRP): PRP is defined as autologous blood with a concentration of platelets above baseline reference values. Traditionally, PRP injections have been used over the last three decades in maxillofacial and plastic surgery. More recently, its use throughout orthopedics and sports medicine has beenwell-established and heavily controversial.[17] The use of PRP injections in the setting of acute or acute-on-chronic musculoskeletal pathology continues to remain debated.  One of the more heavily debated areas regarding PRP use is in the management of moderate knee osteoarthritis. Knee osteoarthritis afflicts a significant portion of the adult population. It has an exorbitantly high impacton the healthcare system, financial resources, and overall disability both in the United States and worldwide.[18][19][20] A recent level I study investigating nearly 200 patients randomized between 3 groups (shamcontrol, hyaluronic acid injections, and leukocyte-poor PRP injections) demonstrated superior patient-reported pain and functional outcome scores at 12-month follow-up in patients managed with PRP injections as opposed to the sham control injection group (normal saline only) and those managed with hyaluronic acid injections.[21] 

    ReviewQuestions

    References

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    Burnouf T. Modern plasma fractionation. Transfus Med Rev. 2007 Apr;21(2):101-17. [PMC free article: PMC7125842][PubMed: 17397761]

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    Benjamin RJ, McLaughlin LS. Plasma components: properties, differences, and uses. Transfusion. 2012 May;52 Suppl 1:9S-19S.[PubMed: 22578375]

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    Peters T. Intracellular precursor forms of plasma proteins: their functions and possible occurrence in plasma. Clin Chem. 1987 Aug;33(8):1317-25.[PubMed: 3301066]

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    Tobias A, Ballard BD, Mohiuddin SS. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Oct 9, 2021. Physiology, Water Balance.[PubMed: 31082103]

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    Stanley M, Killeen RB, Michalski JM. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Feb 17, 2022. Thrombotic Thrombocytopenic Purpura.[PubMed: 28613472]

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    Loomans JI, Lock J, Peters M, Leebeek FW, Cnossen MH, Fijnvandraat K. [Haemophilia]. Ned Tijdschr Geneeskd. 2014;158:A7357.[PubMed: 25351381]

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    Flood VH, Friedman KD, Gill JC, Morateck PA, Wren JS, Scott JP, Montgomery RR. Limitations of the ristocetin cofactor assay in measurement of von Willebrand factor function. J Thromb Haemost. 2009 Nov;7(11):1832-9.[PMC free article: PMC3825106] [PubMed: 19694940]

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    Justiz Vaillant AA, Ramphul K. StatPearls [Internet]. StatPearls Publishing;Treasure Island (FL): Oct 15, 2021. Antibody Deficiency Disorder. [PubMed: 29939682]

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    Heim MU, Meyer B, Hellstern P. Recommendations for the use of therapeutic plasma. Curr Vasc Pharmacol. 2009 Apr;7(2):110-9.[PubMed: 19355994]

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    Garcia-Martinez R, Noiret L, Sen S, Mookerjee R, Jalan R. Albumin infusion improves renal blood flow autoregulation in patients with acute decompensation of cirrhosis and acute kidney injury. Liver Int. 2015 Feb;35(2):335-43.[PubMed: 24620819]

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    Garcia-Martinez R, Caraceni P, Bernardi M, Gines P, Arroyo V, Jalan R. Albumin: pathophysiologic basis of its role in the treatment of cirrhosis and its complications. Hepatology. 2013 Nov;58(5):1836-46.[PubMed: 23423799]

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    Salerno F, Navickis RJ, Wilkes MM. Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials. Clin Gastroenterol Hepatol. 2013 Feb;11(2):123-30.e1.[PubMed: 23178229]

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    Traclet J, Delaval P, Terrioux P, Mornex JF. Augmentation therapy of alpha-1 antitrypsin deficiency associated emphysema. Rev Mal Respir. 2015 Apr;32(4):435-46.[PubMed: 25908241]

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    Wewers MD, Crystal RG. Alpha-1 antitrypsin augmentation therapy. COPD. 2013 Mar;10 Suppl 1:64-7.[PubMed: 23527997]

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    Gosselin R, Hawes E, Moll S, Adcock D. Performance of various laboratory assays in the measurement of dabigatran in patients receiving therapeutic doses: a prospective study based on peak and trough plasma levels. Am J Clin Pathol. 2014 Feb;141(2):262-7.[PubMed: 24436275]

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    McLeod BC. Plasma and plasma derivatives in therapeutic plasmapheresis. Transfusion. 2012 May;52 Suppl 1:38S-44S.[PubMed: 22578370]

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    Hall MP, Band PA, Meislin RJ, Jazrawi LM, Cardone DA. Platelet-rich plasma: current concepts and application in sports medicine. J Am Acad Orthop Surg. 2009 Oct;17(10):602-8.[PubMed: 19794217]

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    Varacallo M, Chakravarty R, Denehy K, Star A. Joint perception and patient perceived satisfaction after total hip and knee arthroplasty in the American population. J Orthop. 2018 Jun;15(2):495-499.[PMC free article: PMC5889697] [PubMed: 29643693]

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    Varacallo MA, Herzog L, Toossi N, Johanson NA. Ten-Year Trends and Independent Risk Factorsfor Unplanned Readmission Following Elective Total Joint Arthroplasty at a Large Urban Academic Hospital. J Arthroplasty. 2017 Jun;32(6):1739-1746. [PubMed: 28153458]

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    Varacallo M, Luo TD, Johanson NA. StatPearls [Internet]. StatPearls Publishing; TreasureIsland (FL): Feb 12, 2022. Total Knee Arthroplasty Techniques. [PubMed: 29763071]

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    Huang Y, Liu X, Xu X, Liu J. Intra-articular injections of platelet-rich plasma, hyaluronic acid or corticosteroids for knee osteoarthritis : A prospective randomized controlled study. Orthopade. 2019Mar;48(3):239-247. [PubMed: 30623236]

    What plasma is made of? : What Is Plasma Made Of? Plasma is made up of about 90% water It also has salts and enzymes And it has antibodies that help fight infection, plus proteins called albumin and fibrinogen
    Read Detail Answer On What plasma is made of?

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    4. Helps to maintain a proper pH balance in the body, which supports cell function.

    What is blood plasma used for?

    Plasma is frequently administered to patients with trauma, burns, and shock as well as those with severe liver disease or multiple clotting factor deficiencies. It aids in increasing the patient’s blood volume, which can help with blood clotting and prevent shock. Treatments for illnesses like immune deficiencies and bleeding disorders are created by pharmaceutical companies using plasma.

    What is a plasma donation?

    In a plasma-only donation, the liquid portion of the donors blood is separated from the cells Blood is drawn from one arm and sent through ahigh-tech machine that collects the plasma The donors red blood cells and platelets are then returned to the donor along with some saline The process is safe and only takes a few minutes longer than donating whole blood

    Within 24 hours of donation, plasma is frozen to protect its valuable clotting factors. When a patient needs a transfusion, it can be frozen and stored for up to a year. Donations to the Red Cross are frequently used for transfusions of hospital patients rather than for pharmaceutical purposes.

    Additional Question — What is a simple definition of plasma?

    Why is plasma so important?

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    Why do people need plasma?

    Blood clotting is essential for preventing excessive bleeding, and plasma plays a crucial role in this process. This is why plasma donations are so crucial because they aid in the treatment of diseases like immune deficiencies, liver disease, and various types of cancer.

    Dannie Jarrod

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