fresh frozen plasma for angioedema

10 May

THE  CONCEPT:

angioedema from multiple etiologies (e.g. hereditary, ACE inhibitors)

some treatments, e.g. FFP, C1 concentrate, derived from hereditary angioedema data

in the ED, may not know the etilogy

if its due to ACE inhibitor use, will FFP still help?

THE NUMBERS:

frequency of ACE inhibitor induced angioedema = 0.1-0.7% (so….rare)

authors reviewed a case series of 7 

TREATMENTS USED:

methylprednisolone (125mg IV)

epinephrine (0.3mg 1:1000 IM)

diphenhydramine (50mg IV)

famotidine (20mg IV)

—no observed response after some hours, so they tried:

FFP (1-3 units)

progression of swelling stopped within 2-4 hrs after FFP given

BOTTOM LINE:

small sample size, but if you’ve thrown everything at ’em but the kitchen sink and there’s no change, might as well try the kitchen sink (e.g. FFP)

don’t forget about controlling that airway, too.

References: JEM article; picture

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