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J Thorac Cardiovasc Surg 1996;112:162-167
© 1996 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

THE ROUTINE USE OF FRESH FROZEN PLASMA IN OPERATIONS WITH CARDIOPULMONARY BYPASS IS NOT JUSTIFIED

Supported in part by a grant from The Regional Red Cross Blood Bank of Amsterdam.

Received for publication Feb. 10, 1995 Accepted for publication July 27, 1995. Address for reprints: M. H. J. van Oers, Department of Hematology, F4-224, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.

Abstract

Background: The negative influence of cardiopulmonary bypass on hemostasis has been documented. Although abnormalities in platelet function are reported as the major cause of postoperative blood loss related to this hemostasis defect, fresh frozen plasma is often used in operations with cardiopulmonary bypass because it is thought to contribute to the reduction of postoperative bleeding complications. This study was designed to evaluate the effect of the administration of fresh frozen plasma after cardiopulmonary bypass on blood loss, transfusion requirements, and a number of coagulation parameters. Methods: In a prospective, randomized, double-blind clinical trial 50 patients (mean age 63 years; 35 men/15 women) undergoing elective operation with cardiopulmonary bypass were randomly assigned to one of two groups: group I (n = 24) received 3 units of fresh frozen plasma after operation and group II (n = 26) received an equal amount of Gelofusine plasma substitute. At seven points before, during, and after operation hemoglobin concentration, hematocrit level, thrombocyte count, and coagulation parameters were analyzed. Study endpoints were the volume of blood loss and the transfusion requirement. Results: There were no significant differences between the two study groups in blood loss, transfusion requirement, coagulation parameters, or thrombocyte counts. Conclusion: The routine use of fresh frozen plasma in operations with cardiopulmonary bypass cannot be recommended. (J THORAC CARDIOVASC SURG 1996;112:162-7)

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