Comparative Analysis of Prothrombin Complex Concentrate and Fresh Frozen Plasma in Coronary Surgery

Fausto Biancari, Vito G. Ruggieri, Andrea Perrotti, Riccardo Gherli, Till Demal, Ilaria Franzese, Magnus Dalen, Giuseppe Santarpino, Antonino S. Rubino, Daniele Maselli, Antonio Salsano, Francesco Nicolini, Matteo Saccocci, Giuseppe Gatti, Stefano Rosato, Paola D'Errigo, Eeva-Maija Kinnunen, Marisa De Feo, Tuomas Tauriainen, Francesco OnoratiGiovanni Mariscalco

Research output: Contribution to journalArticlepeer-review

Abstract

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 (67.27.5 adjusted OR 0.319, 95.136-0.752) and platelet transfusion requirements (11.85.2 adjusted OR 0.238, 95.097-0.566) 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, 953.357-0.494). The use of PCC increased the risk of KDIGO (Kidney Disease: Improving Global Outcomes) acute kidney injury (41.48.2 adjusted OR 2.300, 1.203-4.400), but not of KDIGO acute kidney injury stage 3 (6.0.0 OR 0.850, 95.258-2.796) 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.
Original languageEnglish
Pages (from-to)1881-1887
Number of pages7
JournalHeart Lung and Circulation
Volume28
Issue number12
DOIs
Publication statusPublished - Dec 1 2019

Keywords

  • Prothrombin complex concentrate
  • Fresh frozen plasma
  • Bleeding
  • Transfusion
  • Cardiac surgery

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