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Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery

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Abstract

Purpose

The aim of this study was to examine the relationship between FFP (fresh frozen plasma)/pRBC (packed red blood cell) transfusion ratio and outcomes in patients undergoing cardiovascular surgery.

Methods

This is a single center retrospective cohort study performed in a cardiovascular center. Patients undergoing cardiovascular surgery between January 2012 and October 2016 with or without massive transfusion (n = 1453). Patients’ outcomes were compared based on FFP/pRBC transfusion ratio (FFP/pRBC > 1 or FFP/pRBC ≤ 1).

Results

In hospital mortality and rate of stroke and myocardial infarction was significantly higher in patients with less than 1 of FFP/pRBC transfusion ratio only in patients with massive transfusion (3.0 vs 8.8%, p = 0.001; 0.7 vs 6.4%, p < 0.001; 1.0 vs 3.2%, p = 0.047, respectively).

Conclusions

Higher FFP/RBC ratio was associated with reduced risk of death, stroke and myocardial infarction only in patients with cardiovascular surgery receiving massive transfusion. Clinicians should be aware that judicious FFP replacement plays a critical role in the successful management of massive transfusion in cardiac surgery.

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Acknowledgements

We thank Jane Charbonneau, DVM, from Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Anesthesiology, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Akito Tsukinaga, Takuma Maeda & Yoshihiko Ohnishi

  2. Division of Transfusion Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Takuma Maeda

  3. Department of Anesthesiology and Critical Care Medicine, Yokohama City University School of Medicine, Yokohama, Kanagawa, 236-0004, Japan

    Shunsuke Takaki

  4. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Nobuaki Michihata

  5. Department of Anesthesiology, Yokohama City University Medical Center, Yokohama, Kanagawa, 232-0024, Japan

    Takahisa Goto

Authors
  1. Akito Tsukinaga
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  2. Takuma Maeda
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  3. Shunsuke Takaki
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  4. Nobuaki Michihata
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  5. Yoshihiko Ohnishi
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  6. Takahisa Goto
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Corresponding author

Correspondence to Takuma Maeda.

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Tsukinaga, A., Maeda, T., Takaki, S. et al. Relationship between fresh frozen plasma to packed red blood cell transfusion ratio and mortality in cardiovascular surgery. J Anesth 32, 539–546 (2018). https://doi.org/10.1007/s00540-018-2508-6

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  • DOI: https://doi.org/10.1007/s00540-018-2508-6

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