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

被引：20

作者：

Biancari, Fausto ^{[1
,2
,3
,4
]}

Ruggieri, Vito G. ^{[5
]}

Perrotti, Andrea ^{[6
]}

Gherli, Riccardo ^{[7
]}

Demal, Till ^{[8
]}

Franzese, Ilaria ^{[9
]}

Dalen, Magnus ^{[10
]}

Santarpino, Giuseppe ^{[11
]}

Rubino, Antonino S. ^{[12
]}

Maselli, Daniele ^{[13
]}

Salsano, Antonio ^{[14
]}

Nicolini, Francesco ^{[15
]}

Saccocci, Matteo ^{[16
]}

Gatti, Giuseppe ^{[17
]}

Rosato, Stefano ^{[18
]}

D'Errigo, Paola ^{[18
]}

Kinnunen, Eeva-Maija ^{[3
,4
]}

De Feo, Marisa ^{[19
]}

Tauriainen, Tuomas ^{[3
,4
]}

Onorati, Francesco ^{[9
]}

Mariscalco, Giovanni ^{[20
]}

机构：

[1] Turku Univ Hosp, Heart Ctr, POB 52, FIN-20521 Turku, Finland

[2] Univ Turku, Dept Surg, Turku, Finland

[3] Oulu Univ Hosp, Dept Surg, Oulu, Finland

[4] Univ Oulu, Oulu, Finland

[5] Robert Debre Univ Hosp, Div Cardiothorac & Vasc Surg, Reims, France

[6] Univ Hosp Jean Minjoz, Dept Thorac & Cardio Vasc Surg, Besancon, France

[7] S Camillo Forlanini Hosp, Dept Cardiovasc Sci, Cardiac Surg Unit, Rome, Italy

[8] Hamburg Univ, Heart Ctr, Hamburg, Germany

[9] Verona Univ Hosp, Div Cardiovasc Surg, Verona, Italy

[10] Karolinska Inst, Karolinska Univ Hosp, Dept Mol Med & Surg, Dept Cardiac Surg, Stockholm, Sweden

[11] Paracelsus Med Univ, Cardiovasc Ctr, Nurnberg, Germany

[12] Ctr Clincodiagnost GB Morgagni, Ctr Cuore, Pedara, Italy

[13] St Anna Hosp, Dept Cardiac Surg, Catanzaro, Italy

[14] Univ Genoa, Div Cardiac Surg, Genoa, Italy

[15] Univ Parma, Div Cardiac Surg, Parma, Italy

[16] Ctr Cardiol Fdn Monzino IRCCS, Dept Cardiac Surg, Milan, Italy

[17] Osped Riuniti, Div Cardiac Surg, Trieste, Italy

[18] Ist Super Sanita, Natl Ctr Global Hlth, Rome, Italy

[19] Univ Campania Luigi Vanvitelli, Dept Cardiothorac Sci, Naples, Italy

[20] Univ Leicester, Glenfield Hosp, Dept Cardiovasc Sci, Clin Sci Wing, Leicester, Leics, England

来源：

HEART LUNG AND CIRCULATION | 2019年 / 28卷 / 12期

关键词：

Prothrombin complex concentrate; Fresh frozen plasma; Bleeding; Transfusion; Cardiac surgery; CARDIAC-SURGERY; COAGULOPATHY; COAGULATION; OUTCOMES; RISK; HEMOSTASIS; MANAGEMENT; REVERSAL; MODEL;

D O I：

10.1016/j.hlc.2018.10.025

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1881 / 1887

页数：7

共 24 条

[1] Reversal of warfarin anticoagulation using prothrombin complex concentrate at 25 IU kg-1: results of the RAPID study [J].