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Intraoperative plasmapheresis in cardiac surgery
G Armellin1, C Sorbara, R Bonato
1Department of Anesthesiology and Critical Care, University of Padova, Italy.
Journal of Cardiothoracic and Vascular Anesthesia
|February 1, 1997
Summary
Intraoperative plasmapheresis (IP) in cardiac surgery significantly reduced early postoperative bleeding and the need for blood transfusions. This method decreased mediastinal drainage and transfusion requirements in the intensive care unit.
Area of Science:
- Cardiovascular Surgery
- Transfusion Medicine
- Anesthesiology
Background:
- Cardiac surgery often involves significant blood loss and requires transfusions.
- Minimizing perioperative blood loss and transfusion needs is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the impact of intraoperative plasmapheresis (IP) on transfusion requirements, mediastinal drainage, and coagulation.
- To assess the efficacy of IP in reducing blood loss and the need for homologous transfusions after cardiac surgery.
Main Methods:
- Prospective, randomized, controlled trial involving 293 patients undergoing cardiac surgery with cardiopulmonary bypass.
- Intraoperative plasmapheresis (IP) was administered to 147 patients before heparinization, with immediate reinfusion of platelet-rich plasma post-heparin reversal.
Main Results:
- Significantly less mediastinal chest tube drainage in the first 12 postoperative hours for the IP group (p = 0.022).
- Reduced transfusion of packed red cells (p = 0.02) and fresh frozen plasma (p = 0.002) in the IP group.
- 51.4% of IP patients required no transfusion versus 34.5% in the control group (p = 0.006).
Conclusions:
- Intraoperative plasmapheresis effectively reduces early postoperative bleeding after cardiac surgery.
- IP significantly decreases the requirement for homologous blood product transfusions in the perioperative period.