Document Detail


Failure of autologous fresh frozen plasma to reduce blood loss and transfusion requirements in coronary artery bypass surgery.
MedLine Citation:
PMID:  11465588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Previous studies failed to demonstrate any benefit from prophylaxis with fresh frozen plasma (FFP) after cardiopulmonary bypass (CPB). The results, however, were limited by either retrospective study design or use of FFP in subtherapeutic doses (2-3 units). The authors evaluated whether a therapeutic dose (15 ml/kg) of FFP reduces blood loss and transfusion requirements in elective coronary artery bypass surgery. The risks of multiple allogeneic blood donor exposure were circumvented by using autologous plasma. METHODS: Sixty adult patients scheduled for elective primary coronary artery bypass grafting were randomized to receive, after CPB, an intravenous infusion of 15 ml/kg of either autologous FFP (30 patients) or 6% hydroxyethyl starch 450/0.7 (HES; 30 patients). Autologous plasma was obtained by platelet-poor plasmapheresis several weeks before surgery. Perioperative blood transfusions were administered per protocol. Postoperative blood loss was defined as the chest tube drainage during the first 24 h after surgery. RESULTS: The data from 56 patients (FFP group, 27 patients; HES group, 29 patients) who completed the study according to protocol were analyzed. Median postoperative blood loss was 630 ml (range, 450-1,840 ml) and 830 ml (range, 340-1,980 ml) in the FFP and HES groups, respectively (P = 0.08). Both postoperative (0-24 h) and total perioperative erythrocyte transfusion requirements did not differ significantly between the groups (P = 0.32 and 0.14, respectively). CONCLUSION: The prophylactic administration of a therapeutic dose (15 ml/kg) of autologous FFP after CPB failed to reduce blood loss and transfusion requirements in patients undergoing uncomplicated, elective, primary coronary artery bypass surgery.
Authors:
S M Kasper; T Giesecke; P Limpers; R Sabatowski; U Mehlhorn; C Diefenbach
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Anesthesiology     Volume:  95     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-23     Completed Date:  2001-08-09     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  81-6; discussion 6A     Citation Subset:  AIM; IM    
Affiliation:
Department of Anesthesiology, Krankenhaus Porz am Rhein, Germany. stefan-mario.kasper@medizin.uni-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Loss, Surgical / prevention & control*
Blood Transfusion, Autologous*
Coronary Artery Bypass / adverse effects*
Drainage
Erythrocyte Transfusion
Female
Humans
Male
Middle Aged
Plasma*
Plasmapheresis
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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