Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery

被引：9
作者：
Tsukinaga, Akito [1 ]
Maeda, Takuma [1 ,2 ]
Takaki, Shunsuke [3 ]
Michihata, Nobuaki [4 ]
Ohnishi, Yoshihiko [1 ]
Goto, Takahisa [5 ]
机构：
[1] Natl Cerebral & Cardiovasc Ctr, Dept Anesthesiol, 5-7-1 Fujishirodai, Suita, Osaka 5658565, Japan
[2] Natl Cerebral & Cardiovasc Ctr, Div Transfus Med, 5-7-1 Fujishirodai, Suita, Osaka 5658565, Japan
[3] Yokohama City Univ, Sch Med, Dept Anesthesiol & Crit Care Med, Yokohama, Kanagawa 2360004, Japan
[4] Univ Tokyo, Grad Sch Med, Dept Hlth Serv Res, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1130033, Japan
[5] Yokohama City Univ, Med Ctr, Dept Anesthesiol, Yokohama, Kanagawa 2320024, Japan
来源：
JOURNAL OF ANESTHESIA | 2018年 / 32卷 / 04期
关键词：
Massive transfusion; Massive bleeding; Transfusion ratio; Transfusion; Fresh frozen plasma; MASSIVE TRANSFUSION; HEMORRHAGIC-SHOCK; CARDIAC-SURGERY; VASCULAR-PERMEABILITY; CLINICAL-OUTCOMES; GLYCOCALYX; SURVIVAL; TRAUMA; INFLAMMATION; MODEL;
D O I：
10.1007/s00540-018-2508-6
中图分类号：
R614 [麻醉学];
学科分类号：
100217 ;
摘要：
The aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery. This is a single center retrospective cohort study performed in a cardiovascular center. Patients undergoing cardiovascular surgery between January 2012 and October 2016 with or without massive transfusion (n = 1453). Patients' outcomes were compared based on FFP/pRBC transfusion ratio (FFP/pRBC > 1 or FFP/pRBC ae<currency> 1). In hospital mortality and rate of stroke and myocardial infarction was significantly higher in patients with less than 1 of FFP/pRBC transfusion ratio only in patients with massive transfusion (3.0 vs 8.8%, p = 0.001; 0.7 vs 6.4%, p < 0.001; 1.0 vs 3.2%, p = 0.047, respectively). Higher FFP/RBC ratio was associated with reduced risk of death, stroke and myocardial infarction only in patients with cardiovascular surgery receiving massive transfusion. Clinicians should be aware that judicious FFP replacement plays a critical role in the successful management of massive transfusion in cardiac surgery.
引用
收藏
页码：539 / 546
页数：8
相关论文
共 22 条
[1]   Transfusion utilization during adnexal or peritoneal cancer surgery: Effects on symptomatic venous thromboembolism and survival [J].
Abu-Rustum, NR ;
Richard, S ;
Wilton, A ;
Lev, G ;
Sonoda, Y ;
Hensley, ML ;
Gemignani, M ;
Barakat, RR ;
Chi, DS .
GYNECOLOGIC ONCOLOGY, 2005, 99 (02) :320-326
[2]   The use of propensity score methods with survival or time-to-event outcomes: reporting measures of effect similar to those used in randomized experiments [J].
Austin, Peter C. .
STATISTICS IN MEDICINE, 2014, 33 (07) :1242-1258
[3]   The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital [J].
Borgman, Matthew A. ;
Spinella, Philip C. ;
Perkins, Jeremy G. ;
Grathwohl, Kurt W. ;
Repine, Thomas ;
Beekley, Alec C. ;
Sebesta, James ;
Jenkins, Donald ;
Wade, Charles E. ;
Holcomb, John B. .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2007, 63 (04) :805-813
[4]   Glycocalyx and sepsis-induced alterations in vascular permeability [J].
Chelazzi, Cosimo ;
Villa, Gianluca ;
Mancinelli, Paola ;
De Gaudio, A. Raffaele ;
Adembri, Chiara .
CRITICAL CARE, 2015, 19
[5]   Deep venous thrombosis in medical-surgical critically ill patients: Prevalence, incidence, and risk factors [J].
Cook, D ;
Crowther, M ;
Meade, M ;
Rabbat, C ;
Griffith, L ;
Schiff, D ;
Geerts, W ;
Guyatt, G .
CRITICAL CARE MEDICINE, 2005, 33 (07) :1565-1571
[6]   Massive Transfusion in Cardiac Surgery: The Impact of Blood Component Ratios on Clinical Outcomes and Survival [J].
Delaney, Meghan ;
Stark, Paul C. ;
Suh, Minhyung ;
Triulzi, Darrell J. ;
Hess, John R. ;
Steiner, Marie E. ;
Stowell, Christopher P. ;
Sloan, Steven R. .
ANESTHESIA AND ANALGESIA, 2017, 124 (06) :1777-1782
[7]   Improvements in Early Mortality and Coagulopathy are Sustained Better in Patients With Blunt Trauma After Institution of a Massive Transfusion Protocol in a Civilian Level I Trauma Center [J].
Dente, Christopher J. ;
Shaz, Beth H. ;
Nicholas, Jeffery M. ;
Harris, Robert S. ;
Wyrzykowski, Amy D. ;
Patel, Snehal ;
Shah, Amit ;
Vercruysse, Gat A. ;
Feliciano, David V. ;
Rozycki, Grace S. ;
Salomone, Jeffrey P. ;
Ingram, Walter L. .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2009, 66 (06) :1616-1624
[8]   The Prospective, Observational, Multicenter, Major Trauma Transfusion (PROMMTT) Study Comparative Effectiveness of a Time-Varying Treatment With Competing Risks [J].
Holcomb, John B. ;
del Junco, Deborah J. ;
Fox, Erin E. ;
Wade, Charles E. ;
Cohen, Mitchell J. ;
Schreiber, Martin A. ;
Alarcon, Louis H. ;
Bai, Yu ;
Brasel, Karen J. ;
Bulger, Eileen M. ;
Cotton, Bryan A. ;
Matijevic, Nena ;
Muskat, Peter ;
Myers, John G. ;
Phelan, Herb A. ;
White, Christopher E. ;
Zhang, Jiajie ;
Rahbar, Mohammad H. .
JAMA SURGERY, 2013, 148 (02) :127-136
[9]   The independent association of massive blood loss with mortality in cardiac surgery [J].
Karkouti, K ;
Wijeysundera, DN ;
Yau, TM ;
Beattie, WS ;
Abdelnaem, E ;
McCluskey, SA ;
Ghannam, M ;
Yeo, E ;
Djaiani, G ;
Karski, J .
TRANSFUSION, 2004, 44 (10) :1453-1462
[10]  
Karkouti K, 2006, CAN J ANAESTH, V53, P781, DOI 10.1007/BF03022795
123