Personalized treatment with Fresh Frozen Plasma for the pro-inflammatory septic phenotype characterized by refractory shock, hemodynamic incoherence, and endothelial damage. A proof of concept
Authors
-
Jorge Luis Vélez-Páez
Hospital Pablo Arturo Suárez, Unidad de Terapia Intensiva, Centro de Investigación Clínica, Quito,Ecuador
https://orcid.org/0000-0002-6956-4475
- Esteban Ochoa Unidad de Cuidados Intensivos, Centro de Investigación Clínica, Hospital Pablo Arturo Suárez, Quito, Ecuador
- Franklin Correa Hospital Pablo Arturo Suárez, Unidad de Terapia Intensiva, Centro de Investigación Clínica, Quito,Ecuador
- Glenda Jiménez Hospital Pablo Arturo Suárez, Unidad de Terapia Intensiva, Centro de Investigación Clínica, Quito,Ecuador
DOI:
https://doi.org/10.70099/BJ/2026.03.01.10Keywords:
septic shock, fresh frozen plasma, hemodynamic incoherence, vasopressors, critical careAbstract
This prospective, single-center observational study evaluated the association between early (within the first 24 hours) administration of fresh-frozen plasma (FFP) and clinical outcomes in 30 patients with catecholamine-resistant septic shock, a pro-inflammatory phenotype, and endothelial damage. Patients who received FFP had greater baseline severity, reflected in higher lactate concentrations on admission (5.12 vs. 2.10 mmol/L; p = 0.005), higher initial norepinephrine (NE) doses (0.30 vs. 0.18 µg/kg/min; p = 0.022), and greater use of a second vasopressor (56% vs. 4.8%; p = 0.005). This result suggests that FFP was preferentially used as rescue therapy in patients with greater hemodynamic and metabolic severity. Despite this, vasopressor support showed a progressive reduction in both groups, with significant differences between groups at 24 hours (FFP/control ratio 1.93; p = 0.019), followed by convergence and no further divergence at 48 and 72 hours. Fresh frozen plasma (FFP) demonstrated an acceptable safety profile and early hemodynamic changes, but did not significantly reduce ICU mortality compared to conventional therapy. These findings suggest that, while FFP may have modulating potential, its clinical efficacy remains open to further investigation and warrants larger randomized controlled trials to determine optimal dosage and duration of therapy.
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Copyright (c) 2026 Jorge Luis Vélez-Páez, Esteban Ochoa, Franklin Correa, Glenda Jiménez (Author)
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