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Microfluidics in Assessing Platelet Function
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Microfluidics in Assessing Platelet Function

Published on: November 8, 2024

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Platelet versus fresh frozen plasma transfusion for coagulopathy in cardiac surgery patients

Jake V Hinton1, Calvin M Fletcher2, Luke A Perry3,4

  • 1Department of Anaesthesia, Austin Health, Heidelberg, Australia.

Plos One
|January 17, 2024
PubMed

Insights

Platelets (PLTS) show a mortality benefit over fresh frozen plasma (FFP) for cardiac surgery patients with perioperative bleeding. This finding aids clinicians in selecting procoagulant therapy for better patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Critical Care Medicine

Background:

  • Platelets (PLTS) and fresh frozen plasma (FFP) are commonly used to manage perioperative bleeding in cardiac surgery.
  • The comparative effectiveness of PLTS versus FFP in this patient population remains unclear.

Purpose of the Study:

  • To compare the effectiveness of platelets versus fresh frozen plasma in managing perioperative bleeding in cardiac surgery patients.
  • To evaluate the impact of PLTS and FFP transfusion on operative mortality and other key outcomes.

Main Methods:

  • An entropy-weighted retrospective cohort study was performed using the Australian and New Zealand Society of Cardiac and Thoracic Surgeons National Cardiac Surgery Database.
  • Data from 174,796 adult patients undergoing cardiac surgery between 2005 and 2021 across 58 sites were analyzed.
  • The primary outcome was operative mortality, with secondary outcomes including 1-year mortality, chest drain output, acute kidney injury (AKI), and ICU readmission.

Main Results:

  • Fresh frozen plasma (FFP) transfusion was associated with increased perioperative (RR, 1.63) and 1-year (RR, 1.50) mortality compared to platelets (PLTS).
  • FFP was also linked to higher rates of 4-hour chest drain output (28.37 ml increase), AKI (RR, 1.13), and ICU readmission (RR, 1.24).
  • The study included a large cohort, with 15,360 patients receiving PLTS and 6,189 receiving FFP in the absence of the other product.

Conclusions:

  • Platelets (PLTS) demonstrate a relative mortality benefit compared to fresh frozen plasma (FFP) in patients experiencing perioperative bleeding during cardiac surgery.
  • These findings provide crucial evidence to guide clinicians in choosing appropriate procoagulant therapy for cardiac surgery patients.
  • The study highlights the importance of considering transfusion strategies for optimizing patient outcomes in this high-risk group.
Abstract

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