| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 1007-1013, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
CE Tobe, C Vocelka, R Sepulvada, B Gillis, M Nessly, ED Verrier and BO Hofer
Prior nonblinded studies have suggested dramatic hemostatic effects and
decreased plasma after cardiopulmonary bypass. Platelet rich plasma (8 to
10 ml/kg total body weight) was obtained (Haemonetics Plasma Saver;
Haemonetics Corp., Natick, Mass.) from 51 patients undergoing primary
coronary artery bypass grafting before heparinization. After double-
blinded randomization, the platelet rich plasma was reinfused immediately
in the control group or after heparin reversal in the treatment group.
Homologous blood product usage, blood loss, and the surgeon's
intraoperative subjective assessment of coagulation were evaluated.
Additionally, thromboelastography, prothrombin time, partial thromboplastin
time, activated clotting time, fibrinogen, platelet counts, and hematocrit
values were evaluated before the operation, after heparin reversal, after
infusion of platelet rich plasma or control solution, and 2 hours after
infusion. The surgeon's subjective assessment of coagulation was not
different between control and treatment groups (p = 0.78). According to
specific predetermined transfusion guidelines, no statistically significant
differences were found in the use of whole blood (p = 0.07), packed red
blood cells (p = 0.62), platelets (p = 0.11), total units of blood products
(p = 0.45), or in the percentage of patients receiving transfusions
(control group 70%, treatment group 71%, p = 0.97). Cumulative amount of
blood shed through the chest tube was not significantly different between
the groups at any interval but tended toward significance at 4, 6, and 12
hours (p = 0.09, 0.07, and 0.09). The prothrombin time immediately after
reinfusion of platelet rich plasma was significantly lower in the treatment
group (p = 0.03), but all other laboratory studies were similar at each
time interval. Infusion of platelet rich plasma after cardiopulmonary
bypass in patients having uncomplicated primary coronary artery bypass
grafting has minimal effects on the surgeon's assessment of coagulation,
total transfusion requirements, mediastinal drainage, and laboratory
studies of coagulation.
ARTICLES
Infusion of autologous platelet rich plasma does not reduce blood loss and product use after coronary artery bypass. A prospective, randomized, blinded study
Division of Cardiothoracic Surgery, University of Washington Medical Center, Seattle 98195.
This article has been cited by other articles:
|
|
 |
|
  L. Y. Lee, W. J. DeBois, K. H. Krieger, and O. W. Isom Transfusion Therapy and Blood Conservation Card. Surg. Adult, January 1, 2008; 3(2008): 415 - 430. [Full Text]
|
|
|
|
 |
|
 The Society of Thoracic Surgeons Blood Conservatio, V. A. Ferraris, S. P. Ferraris, S. P. Saha, E. A. Hessel II, C. K. Haan, B. D. Royston, C. R. Bridges, R. S.D. Higgins, G. Despotis, et al. Perioperative Blood Transfusion and Blood Conservation in Cardiac Surgery: The Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists Clinical Practice Guideline Ann. Thorac. Surg., May 1, 2007; 83(5_Supplement): S27 - S86. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Y. Lee, W. J. DeBois, K. H. Krieger, and O. W. Isom Transfusion Therapy and Blood Conservation Card. Surg. Adult, January 1, 2003; 2(2003): 389 - 400. [Full Text]
|
|
|
|
 |
|
 P. R. Belcher, E. W. Muriithi, P. Wajon, and J. Gibson Postoperative Bleeding After Coronary Artery Bypass Surgery with Cardiopulmonary Bypass * Response Anesth. Analg., November 1, 2002; 95(5): 1466 - 1467. [Full Text] [PDF]
|
|
|
|
|
|
T. Hiramatsu, T. Okamura, Y. Imai, H. Kurosawa, M. Aoki, T. Shin'oka, and Y. Takanashi Effects of autologous platelet concentrate reinfusion after open heart surgery in patients with congenital heart disease Ann. Thorac. Surg., April 1, 2002; 73(4): 1282 - 1285. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Kottke-Marchant and S. Sapatnekar Hemostatic Abnormalities in Cardiopulmonary Bypass: Pathophysiologic and Transfusion Considerations Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2001; 5(3): 187 - 206. [Abstract] [PDF]
|
|
|
|
|
|
P. Wajon, J. Gibson, R. Calcroft, C. Hughes, and B. Thrift Intraoperative Plateletpheresis and Autologous Platelet Gel Do Not Reduce Chest Tube Drainage or Allogeneic Blood Transfusion After Reoperative Coronary Artery Bypass Graft Anesth. Analg., September 1, 2001; 93(3): 536 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. P. Stover, L. C. Siegel, P. A. Hood, G. E. O’Riordan, and T. R. McKenna Platelet-Rich Plasma Sequestration, with Therapeutic Platelet Yields, Reduces Allogeneic Transfusion in Complex Cardiac Surgery Anesth. Analg., March 1, 2000; 90(3): 509 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. T. Christenson, J. Reuse, P. Badel, F. Simonet, and M. Schmuziger Plateletpheresis Before Redo CABG Diminishes Excessive Blood Transfusion Ann. Thorac. Surg., November 1, 1996; 62(5): 1373 - 1378. [Abstract] [Full Text]
|
|
|
|
|
|
R. E. Helm, J. D. Klemperer, T. K. Rosengart, J. P. Gold, P. Peterson, W. DeBois, N. K. Altorki, S. Lang, S. Thomas, O. W. Isom, et al. Intraoperative Autologous Blood Donation Preserves Red Cell Mass But Does Not Decrease Postoperative Bleeding Ann. Thorac. Surg., November 1, 1996; 62(5): 1431 - 1441. [Abstract] [Full Text]
|
|
|
|
 |
|
 E. P. Stover and L. C. Siegel Platelet-rich plasmapheresis in cardiac surgery: Efficacy may yet be demonstrated J. Thorac. Cardiovasc. Surg., December 1, 1994; 108(6): 1148 - 1148. [Full Text]
|
|
|
|
 |
|
 Z. A Varga Autologous plateletpheresis in cardiac surgery Perfusion, November 1, 1993; 8(6): 471 - 476. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
