Akito Tsukinaga1, Takuma Maeda2,3, Shunsuke Takaki4, Nobuaki Michihata5, Yoshihiko Ohnishi1, Takahisa Goto6. 1. Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan. 2. Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan. takuma@ncvc.go.jp. 3. Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan. takuma@ncvc.go.jp. 4. Department of Anesthesiology and Critical Care Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa, 236-0004, Japan. 5. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. 6. Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Kanagawa, 232-0024, Japan.
Abstract
PURPOSE: 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. METHODS: 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 ≤ 1). RESULTS: 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). CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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 ≤ 1). RESULTS: 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). CONCLUSIONS: 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.
Authors: Susan E Rowell; Ronald R Barbosa; Carrie E Allison; Philbert Y Van; Martin A Schreiber; J B Holcomb; C E Wade; K J Brasel; G Vercruysse; J MacLeod; R P Dutton; J R Hess; J C Duchesne; N E McSwain; P Muskat; J Johannigamn; H M Cryer; A Tillou; M J Cohen; J F Pittet; P Knudson; M A De Moya; M A Schreiber; B Tieu; S Brundage; L M Napolitano; M Brunsvold; K C Sihler; G Beilman; A B Peitzman; M S Zenait; J Sperry; L Alarcon; M A Croce; J P Minei; R Kozar; E A Gonzalez; R M Stewart; S M Cohn; J E Mickalek; E M Bulger; B A Cotton; T C Nunez; R Ivatury; J W Meredith; P Pomper; G J Pomper; B Marin Journal: J Trauma Date: 2011-08
Authors: Susan E Rowell; Ronald R Barbosa; Brian S Diggs; Martin A Schreiber; J B Holcomb; C E Wade; K J Brasel; G Vercruysse; J MacLeod; R P Dutton; J R Hess; J C Duchesne; N E McSwain; P Muskat; J Johannigamn; H M Cryer; A Tillou; M J Cohen; J F Pittet; P Knudson; M A De Moya; M A Schreiber; B Tieu; S Brundage; L M Napolitano; M Brunsvold; K C Sihler; G Beilman; A B Peitzman; M S Zenait; J Sperry; L Alarcon; M A Croce; J P Minei; R Kozar; E A Gonzalez; R M Stewart; S M Cohn; J E Mickalek; E M Bulger; B A Cotton; T C Nunez; R Ivatury; J W Meredith; P Miller; G J Pomper; B Marin Journal: J Trauma Date: 2011-08
Authors: Deborah Cook; Mark Crowther; Maureen Meade; Christian Rabbat; Lauren Griffith; David Schiff; William Geerts; Gordon Guyatt Journal: Crit Care Med Date: 2005-07 Impact factor: 7.598
Authors: Meghan Delaney; Paul C Stark; Minhyung Suh; Darrell J Triulzi; John R Hess; Marie E Steiner; Christopher P Stowell; Steven R Sloan Journal: Anesth Analg Date: 2017-06 Impact factor: 5.108
Authors: Bruce D Spiess; David Royston; Jerrold H Levy; Jane Fitch; Wulf Dietrich; Simon Body; John Murkin; Andrea Nadel Journal: Transfusion Date: 2004-08 Impact factor: 3.157
Authors: Matthew A Borgman; Philip C Spinella; Jeremy G Perkins; Kurt W Grathwohl; Thomas Repine; Alec C Beekley; James Sebesta; Donald Jenkins; Charles E Wade; John B Holcomb Journal: J Trauma Date: 2007-10
Authors: Rolf Rossaint; Bertil Bouillon; Vladimir Cerny; Timothy J Coats; Jacques Duranteau; Enrique Fernández-Mondéjar; Daniela Filipescu; Beverley J Hunt; Radko Komadina; Giuseppe Nardi; Edmund A M Neugebauer; Yves Ozier; Louis Riddez; Arthur Schultz; Jean-Louis Vincent; Donat R Spahn Journal: Crit Care Date: 2016-04-12 Impact factor: 9.097
Authors: Pierre Tibi; R Scott McClure; Jiapeng Huang; Robert A Baker; David Fitzgerald; C David Mazer; Marc Stone; Danny Chu; Alfred H Stammers; Tim Dickinson; Linda Shore-Lesserson; Victor Ferraris; Scott Firestone; Kalie Kissoon; Susan Moffatt-Bruce Journal: J Extra Corpor Technol Date: 2021-06