In the Field
FDP solves the cold-chain problem that limited plasma availability at the point of injury. Liquid plasma requires refrigeration (1 to 6 degrees C) and has a shelf life of 26 to 40 days. Frozen plasma requires deep freeze storage and thaws over 30 to 60 minutes. Neither is compatible with the ruck-carry, multi-day operational profile that forward tactical medicine demands. FDP rides at room temperature, reconstitutes with sterile water in 3 to 5 minutes, and delivers approximately the same coagulation factor content as a unit of liquid plasma. The operational advantage is significant: a casualty in hemorrhagic shock can receive plasma resuscitation at the point of injury rather than waiting for evacuation to refrigerated capability.
Common Mistake
Treating FDP as a complete blood replacement. FDP provides clotting factors and volume but not red cells or oxygen-carrying capacity. In a casualty with significant hemorrhage, FDP is part of the resuscitation strategy, not the complete answer. The TCCC fluid hierarchy still prefers whole blood when available; FDP fills the operational gap where whole blood logistics are not feasible. The other mistake is improper reconstitution. FDP products have specific reconstitution protocols (sterile water volume, mixing technique, time to use); failure to follow them produces ineffective or contaminated product.
Technical Detail
FDP products: LyoPlas N-w (French Military Health Service, also used by German Bundeswehr); Octaplas (FDA-approved, manufactured by Octapharma); other national variants in development or use. Manufacturing: pooled or single-donor plasma is freeze-dried (lyophilized) into a powder form sealed in glass containers. Storage: room temperature (typically up to 25 degrees C); shelf life approximately 2 years. Reconstitution: add sterile water (volume specified by manufacturer, typically 200 to 250 mL) to the freeze-dried product; gentle mixing produces clear yellow plasma solution in 3 to 5 minutes; transfusion follows standard plasma administration. ABO compatibility considerations: pooled FDP products are typically AB-blood-type compatible (universal plasma donor); single-donor FDP follows donor blood type. Coagulation factor content approximately equivalent to fresh plasma. TCCC 2026 fluid resuscitation hierarchy includes plasma in multiple positions: 1:1:1 ratio with RBC and platelets; 1:1 ratio with RBC; or alone when other components unavailable. For moderate or severe TBI without hemorrhagic shock, 1 to 2 units of plasma are recommended. US Armed Services Blood Program has deployed FDP through Special Operations Command and is expanding to broader joint use.
