Comparative Analysis of Prothrombin Complex Concentrate and Fresh Frozen Plasma in Coronary Surgery
| Autor: | Till Demal, Ilaria Franzese, Marisa De Feo, Magnus Dalén, Tuomas Tauriainen, Andrea Perrotti, Paola D'Errigo, Giovanni Mariscalco, Antonio Salsano, Stefano Rosato, Vito G. Ruggieri, Daniele Maselli, Francesco Onorati, Matteo Saccocci, Antonino S. Rubino, Fausto Biancari, Francesco Nicolini, Giuseppe Santarpino, Eeva-Maija Kinnunen, Giuseppe Gatti, Riccardo Gherli |
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| Přispěvatelé: | Biancari, Fausto, Ruggieri, Vito G., Perrotti, Andrea, Gherli, Riccardo, Demal, Till, Franzese, Ilaria, Dalén, Magnu, Santarpino, Giuseppe, Rubino, Antonino S., Maselli, Daniele, Salsano, Antonio, Nicolini, Francesco, Saccocci, Matteo, Gatti, Giuseppe, Rosato, Stefano, D'Errigo, Paola, Kinnunen, Eeva-Maija, De Feo, Marisa, Tauriainen, Tuoma, Onorati, Francesco, Mariscalco, Giovanni |
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Blood transfusion medicine.medical_treatment Platelet Transfusion 030204 cardiovascular system & hematology 03 medical and health sciences Plasma 0302 clinical medicine Fresh frozen plasma Medicine Humans 030212 general & internal medicine Coronary Artery Bypass Aged Aged 80 and over business.industry Prothrombin complex concentrate Transfusion Bleeding Acute kidney injury ta3121 Cardiac surgery Acute Kidney Injury Middle Aged medicine.disease Blood Coagulation Factors Platelet transfusion Anesthesia Cohort Female business Cardiology and Cardiovascular Medicine Erythrocyte Transfusion Kidney disease medicine.drug |
| Zdroj: | Heart, lungcirculation. 28(12) |
| ISSN: | 1444-2892 |
| Popis: | Background Recent studies suggested that prothrombin complex concentrate (PCC) might be more effective than fresh frozen plasma (FFP) to reduce red blood cell (RBC) transfusion requirement after cardiac surgery. Methods This is a comparative analysis of 416 patients who received FFP postoperatively and 119 patients who received PCC with or without FFP after isolated coronary artery bypass grafting (CABG). Results Mixed-effects regression analyses adjusted for multiple covariates and participating centres showed that PCC significantly decreased RBC transfusion (67.2% vs. 87.5%, adjusted OR 0.319, 95%CI 0.136–0.752) and platelet transfusion requirements (11.8% vs. 45.2%, adjusted OR 0.238, 95%CI 0.097–0.566) compared with FFP. The PCC cohort received a mean of 2.7 ± 3.7 (median, 2.0, IQR 4) units of RBC and the FFP cohort received a mean of 4.9 ± 6.3 (median, 3.0, IQR 4) units of RBC (adjusted coefficient, -1.926, 95%CI -3.357–0.494). The use of PCC increased the risk of KDIGO (Kidney Disease: Improving Global Outcomes) acute kidney injury (41.4% vs. 28.2%, adjusted OR 2.300, 1.203–4.400), but not of KDIGO acute kidney injury stage 3 (6.0% vs. 8.0%, OR 0.850, 95%CI 0.258–2.796) when compared with the FFP cohort. Conclusions These results suggest that the use of PCC compared with FFP may reduce the need of blood transfusion after CABG. |
| Databáze: | OpenAIRE |
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