Is transfusion of fresh plasma after cardiac operations indicated?

U. Martinowitz, D. A. Goor*, B. Ramot, R. Mohr

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

26 Scopus citations

Abstract

Patients undergoing cardiac operations constitute the majority of recipients of fresh frozen plasma. In most centers the reason for transfusing fresh frozen plasma is to replace clotting factors. However, the decrease of clotting factors during cardiopulmonary bypass is not sufficient in most patients to cause abnormal bleeding. One of the major causes of nonsurgical bleeding after cardiac operations is acquired platelet dysfunction, which can be corrected of 1 unit of fresh whole blood. Because plasmatic factors in fresh whole blood may be responsible for this improvement, a study was designated to evaluate the effect of transfusing fresh plasma on platelet function after cardiac operations. Forty patients undergoing cardiopulmonary bypass were randomized to receive either fresh plasma or the fresh packed cell fraction. Administration of packed cells increased platelet number (118 ± 8.5 to 154 ± 7.6 x 109/L, p < 0.05), shortened bleeding time (7.57 ± 0.4 to 4.0 ± 0.3 minutes, p < 0.05), and improved platelet aggregation in response to collagen and epinephrine (32% ± 4.7% to 50% ± 5.6% and 37% ± 5.8% to 50% ± 5.8%, respectively, p < 0.05). Fresh plasma, however, neither increased platelet number nor improved bleeding time or platelet aggregation. Each group later received the remainder of the blood unit, with similar results. The results suggest that improvement of platelet function in patients receiving fresh whole blood after cardiac operations is not related to plasmatic factors. Therefore the massive use of fresh frozen plasma in patients after cardiopulmonary bypass should be reconsidered.

Original languageEnglish
Pages (from-to)92-98
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume100
Issue number1
DOIs
StatePublished - 1990
Externally publishedYes

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