Fresh Frozen Plasma Versus Solvent Detergent Plasma for Cardiopulmonary Bypass Priming in Neonates and Infants Undergoing Cardiac Surgery : A Retrospective Cohort Study

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved..

OBJECTIVE: Compared with fresh frozen plasma (FFP), Omniplasma has been attributed to an increased coagulation potential and an increased fibrinolytic potential. This study aimed to compare Omniplasma and FFP used for cardiopulmonary bypass (CPB) priming regarding the incidence of postoperative thrombotic or hemorrhagic complications and outcomes in pediatric patients undergoing cardiac surgery.

DESIGN: A retrospective observational cohort study SETTING: This single-center study was performed at the University Medical Center Groningen.

PARTICIPANT: All pediatric patients up to 10 kg undergoing cardiac surgery with CPB.

INTERVENTIONS: Procedures in which FFP was used for CPB priming were compared with those in which Omniplasma was used.

MEASUREMENTS AND MAIN RESULTS: The primary outcome parameter was a composite endpoint consisting of the following: (1) pediatric intensive care unit (PICU) mortality, (2) thromboembolic complications, and (3) hemorrhagic complications during PICU stay. The authors included 143 procedures in the analyses, 90 (63%) in the FFP group and 53 (37%) in the Omniplasma group. The occurrence of the combined primary endpoint (FFP 20% v Omniplasma 11%, p = 0.18) and its components did not differ between the used CPB priming agent). Omniplasma for CPB priming was associated with decreased unfractionated heparin administration per kg bodyweight (585 IU v 510 IU, p = 0.03), higher preoperative and postoperative activated clotting times (ACT) discrepancy (90% v 94%, p = 0.03), a lower postoperative ACT value (125 v 118 seconds, p = 0.01), and less red blood cell transfusion per kilogram bodyweight (78 v 55 mL, p = 0.02). However, none of the variables differed statistically significantly in the multivariate logistic regression analyses.

CONCLUSIONS: The authors did not find an association between the plasma used for CPB priming and thromboembolic and hemorrhagic complications and death in neonates and infants undergoing cardiac surgery. Omniplasma seems to be safe to use in this population.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:38

Enthalten in:

Journal of cardiothoracic and vascular anesthesia - 38(2024), 5 vom: 22. Apr., Seite 1144-1149

Sprache:

Englisch

Beteiligte Personen:

van Minnen, Olivier [VerfasserIn]
van den Bergh, Walter M [VerfasserIn]
Kneyber, Martin C J [VerfasserIn]
Accord, Ryan E [VerfasserIn]
Buys, Dedré [VerfasserIn]
Meier, Sascha [VerfasserIn]

Links:

Volltext

Themen:

9005-49-6
Cardiopulmonary bypass
Detergents
Fresh frozen plasma
Heparin
Journal Article
Observational Study
Solvent detergent plasma

Anmerkungen:

Date Completed 09.04.2024

Date Revised 09.04.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1053/j.jvca.2024.01.021

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM368732843