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Related Experiment Videos

Prophylactic platelet administration during massive transfusion. A prospective, randomized, double-blind clinical

R L Reed, D Ciavarella, D M Heimbach

    Annals of Surgery
    |January 1, 1986
    PubMed
    Summary

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    Prophylactic platelet concentrates (PLT) are not routinely recommended for preventing microvascular bleeding (MVB) during massive transfusions. Fresh frozen plasma (FFP) showed similar outcomes to PLT in preventing MVB.

    Area of Science:

    • Transfusion Medicine
    • Hematology
    • Critical Care Medicine

    Background:

    • Dilutional thrombocytopenia is a suspected cause of microvascular, nonmechanical bleeding (MVB) in patients receiving massive transfusions.
    • Previous studies at Harborview Medical Center indicated a significant role for dilutional thrombocytopenia in MVB.

    Purpose of the Study:

    • To compare the prophylactic efficacy of platelet concentrates (PLT) versus fresh frozen plasma (FFP) in preventing MVB during massive transfusion.
    • To determine if routine prophylactic PLT administration is warranted for MVB prevention.

    Main Methods:

    • A prospective, randomized, double-blind clinical study was conducted.
    • Patients undergoing massive transfusion (≥12 units in 12 hours) received either 6 units of PLT or 2 units of FFP with every 12 units of modified whole blood.

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  • Incidence of MVB was compared between the two groups.

    • Main Results:

    • Three of 17 patients receiving PLT developed MVB, and three of 16 patients receiving FFP developed MVB, with no significant difference between groups.
    • Platelet counts during transfusion did not differ significantly between PLT and FFP groups.
    • Only one patient exhibited dilutional thrombocytopenia as the cause of MVB, contradicting the initial hypothesis.

    Conclusions:

    • Routine prophylactic administration of platelet concentrates is not a warranted measure to prevent microvascular, nonmechanical bleeding in patients undergoing massive transfusion.
    • Fresh frozen plasma appears to be as effective as platelet concentrates in preventing MVB in this context.
    • Dilutional thrombocytopenia is likely not the primary cause of MVB in most massive transfusion scenarios.