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What About Plasma?-Reply

Lee C. Vermeulen Jr, MS; Thomas A. Ratko, PhD; Karl A. Matuszewski, MS; Brian L. Erstad, PharmD; Mark E. Brecher, MD
Arch Intern Med. 1995;155(16):1817. doi:10.1001/archinte.1995.00430160171021.
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In reply  We appreciate Stricker's comment on our article1; however, the principal purpose of our report was to describe a novel process for developing consensus and only secondarily to present a set of guidelines. It should be noted that our guidelines focused only on colloid and crystalloid solutions. With the exception of a brief mention in the hemorrhagic shock criteria, indications for other blood products such as plasma and packed red blood cells were not considered. There are numerous indications (such as thrombotic thrombocytopenic purpura) for which plasma, red blood cells, or platelets are clearly the volume replacement of choice. It would seem that a global qualifier to the guidelines stating that "crystalloid and colloid solutions should not be considered substitutes for blood or blood components when oxygen-carrying capacity is reduced and/or when replenishment of specific factors or platelets is required" would have been desirable.While practice guidelines are


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