Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery: a prospective, single-blinded, randomised study.

Autor: Lunen TB; Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.; Department of Anesthesiology, SUH Zealand University Hospital Koege, Region Zealand, Denmark., Johansson PI; Department of Transfusion Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.; Department of Surgery, University of Texas Health Medical School, Houston, Texas, USA., Jensen LP; Department of Anesthesiology, SUH Zealand University Hospital Koege, Region Zealand, Denmark.; Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Homburg KM; Department of Clinical Immunology, Naestved Sygehus, Naestved, Denmark., Roeder OC; Department of Vascular Surgery, Odense University Hospital, Odense, Denmark., Lonn L; Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.; Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Secher NH; Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Helgstrand U; Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Carstensen M; Vascular Surgery, Region Zealand, Slagelse Hospital, Slagelse, Denmark., Jensen KB; Department of Statistics, Panum Institutet, University of Copenhagen, Copenhagen, Denmark., Lange T; Department of Statistics, Panum Institutet, University of Copenhagen, Copenhagen, Denmark.; Center for Statistical Science, Peking University, Beijing, China., Sillesen H; Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Swiatek F; Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark., Nielsen HB; Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.; Sanos as, Sanos Clinic, Herlev, Denmark.
Jazyk: angličtina
Zdroj: Transfusion medicine (Oxford, England) [Transfus Med] 2018 Oct; Vol. 28 (5), pp. 386-391. Date of Electronic Publication: 2018 May 21.
DOI: 10.1111/tme.12540
Abstrakt: Background: In patients undergoing open surgery for a ruptured abdominal aortic aneurysm (rAAA), survivors demonstrate a high platelet count, and proactive administration of platelets (and fresh frozen plasma) appears to influence mortality.
Objectives: This trial investigated the effect of platelets administered before transport to surgery.
Methods: In a prospective study design, patients were randomised to receive platelets (intervention; n = 61) or no platelets (control; n = 61) before transport to vascular surgery from 11 local hospitals. The study was terminated when one of the vascular surgical centres implemented endovascular repair for rAAA patients.
Results: Thirty days after surgery, mortality was 36% for patients with intervention vs 31% for controls (P = 0·32). Post-operative thrombotic events (14 vs 15; P = 0·69), renal failure (11 vs 10; P = 0·15) and pulmonary insufficiency (34 vs 39; P = 0·15) were similar in the two groups of patients. No adverse reactions to platelet administration were observed. In addition, length of stay in the intensive care unit was unaffected by intervention.
Conclusions: For patients planned for open repair of a rAAA, we observed no significant effect of early administration of platelets with regard to post-operative complications and stay in the ICU or in hospital and also no significant effect on mortality.
(© 2018 British Blood Transfusion Society.)
Databáze: MEDLINE
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