TY - JOUR
T1 - Comparative Analysis of Prothrombin Complex Concentrate and Fresh Frozen Plasma in Coronary Surgery
AU - Biancari, Fausto
AU - Ruggieri, Vito G.
AU - Perrotti, Andrea
AU - Gherli, Riccardo
AU - Demal, Till
AU - Franzese, Ilaria
AU - Dalen, Magnus
AU - Santarpino, Giuseppe
AU - Rubino, Antonino S.
AU - Maselli, Daniele
AU - Salsano, Antonio
AU - Nicolini, Francesco
AU - Saccocci, Matteo
AU - Gatti, Giuseppe
AU - Rosato, Stefano
AU - D'Errigo, Paola
AU - Kinnunen, Eeva-Maija
AU - De Feo, Marisa
AU - Tauriainen, Tuomas
AU - Onorati, Francesco
AU - Mariscalco, Giovanni
PY - 2019/12/1
Y1 - 2019/12/1
N2 - 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.
AB - 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.
KW - Prothrombin complex concentrate
KW - Fresh frozen plasma
KW - Bleeding
KW - Transfusion
KW - Cardiac surgery
U2 - 10.1016/j.hlc.2018.10.025
DO - 10.1016/j.hlc.2018.10.025
M3 - Article
VL - 28
SP - 1881
EP - 1887
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
SN - 1443-9506
IS - 12
ER -