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Coagulation ability when separating from cardiopulmonary bypass with and without fresh frozen plasma: a pilot study

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Abstract

Objective

Several strategies are employed for administering fresh frozen plasma (FFP) during weaning from cardiopulmonary bypass (CPB). This study evaluated by coagulation function aimed to compare two strategies of administering FFP in cardiovascular surgery: administering 4 units of FFP before separating from CPB or administering it after weaning from CPB.

Methods

Thirty patients who underwent CPB and were expected to receive 8 units of FFP and 20 units of platelet concentrate were randomly allocated into group A (8 units of FFP and 20 units of platelet concentrate administered after separating from CPB) and group B (4 units of FFP administered before separation, and 4 units of FFP and 20 units of platelet concentrate administered after separating from CPB). Thromboelastography (TEG6s®, HAEMONETICS Japan GK, Tokyo, Japan) was conducted at four time points before and after separation. Blood test results, blood loss, and required amounts of blood transfusion were compared. The primary outcome was the difference in coagulation function evaluated by TEG6s 90 min after protamine administration.

Results

Twenty-eight patients were enrolled in the study. Coagulation function after separating from CPB was not significantly different between the groups. Additionally, no significant differences were found in intensive care unit outcomes, such as 24-h transfusion requirements.

Conclusions

Coagulation function 90 min after separating from CPB was not significantly different between the groups. Prior FFP administration before separation did not provide significant improvement in coagulation function.

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Acknowledgements

We thank all cardiovascular surgery and anesthesiology medical staff members and all extra-corporeal technology staff at Japanese Red Cross Nagoya Daiichi Hospital.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Anesthesiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-Ku, Nagoya, 466-8550, Japan

    Takahiro Tamura & Kimitoshi Nishiwaki

  2. Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Takahiro Tamura & Jonathan H. Waters

  3. Division of Anesthesiology, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    Shuichi Yokota

  4. Division of Cardiovascular Surgery, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    Toshiaki Ito

  5. Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan

    Masahiko Ando

  6. Department of Preventive Medicine, Nagoya University Hospital, Nagoya, Japan

    Yoko Kubo

Authors
  1. Takahiro Tamura
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  2. Shuichi Yokota
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  3. Toshiaki Ito
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  4. Masahiko Ando
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  5. Yoko Kubo
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  7. Kimitoshi Nishiwaki
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Corresponding author

Correspondence to Takahiro Tamura.

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JHW is a member of the advisory committee for Haemonetics, Inc. Other authors have no conflict of interest to declare.

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Tamura, T., Yokota, S., Ito, T. et al. Coagulation ability when separating from cardiopulmonary bypass with and without fresh frozen plasma: a pilot study. Gen Thorac Cardiovasc Surg 68, 1361–1368 (2020). https://doi.org/10.1007/s11748-020-01372-9

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  • DOI: https://doi.org/10.1007/s11748-020-01372-9

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