Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/34685
Title: Fresh frozen plasma transfusion after cardiac surgery.
Austin Authors: Fletcher, Calvin M;Hinton, Jake V;Xing, Zhongyue;Perry, Luke A;Karamesinis, Alexandra;Shi, Jenny;Penny-Dimri, Jahan C;Ramson, Dhruvesh;Liu, Zhengyang;Smith, Julian A;Segal, Reny;Coulson, Tim G ;Bellomo, Rinaldo 
Affiliation: Department of Anaesthesiology and Perioperative Medicine, The Alfred Hospital, Melbourne, VIC, Australia.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC, Australia.
Department of Surgery (School of Clinical Sciences at Monash Health), Monash University, Clayton, VIC, Australia.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC, Australia.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Parkville, VIC, Australia.;Department of Critical Care, University of Melbourne, Parkville, VIC, Australia.
Department of Anaesthesiology and Perioperative Medicine, The Alfred Hospital, Melbourne, VIC, Australia.;Department of Critical Care, University of Melbourne, Parkville, VIC, Australia.;Department of Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, VIC, Australia.
Department of Critical Care, University of Melbourne, Parkville, VIC, Australia.;Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia.;Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia.;Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia.
Intensive Care
Issue Date: 12-Dec-2023
Date: 2023
Publication information: Perfusion 2023-12-12
Abstract: Fresh frozen plasma (FFP) transfusion in the intensive care unit (ICU) is commonly used to treat coagulopathy and bleeding in cardiac surgery, despite suggestion that it may increase the risk of morbidity and mortality through mechanisms such as fluid overload and infection. We retrospectively studied consecutive adults undergoing cardiac surgery from the Medical Information Mart for Intensive Care III and IV databases. We applied propensity score matching to investigate the independent association of within-ICU FFP transfusion with mortality and other key clinical outcomes. Of our 12,043 adults who met inclusion criteria, 1585 (13.2%) received perioperative FFP with a median of 2.48 units per recipient (interquartile range [IQR]: 2.04, 4.33) at a median time of 1.83 h (IQR: 0.75, 3.75) after ICU admission. After propensity matching of 952 FFP recipients to 952 controls, we found no significant association between FFP use and hospital mortality (odds ratio (OR): 1.58; 99% confidence interval (CI): 0.57, 3.71), suspected infection (OR: 0.72; 99% CI: 0.49, 1.08), or acute kidney injury (OR: 1.23; 99% CI: 0.91, 1.67). However, FFP was associated with increased days in hospital (adjusted mean difference (AMD): 1.28; 99% CI: 0.27, 2.41; p = .0050), days in intensive care (AMD: 1.28; 99% CI: 0.27, 2.28; p = .0011), and chest tube output in millilitres up to 8 h after transfusion (AMD: 92.98; 99% CI: 52.22, 133.74; p < .0001). After propensity matching, FFP transfusion was not associated with increased hospital mortality, but was associated with increased length of stay and no decrease in bleeding in the early post-transfusion period.
URI: https://ahro.austin.org.au/austinjspui/handle/1/34685
DOI: 10.1177/02676591231221715
ORCID: 0000-0001-7582-9145
0000-0002-5119-973X
0000-0002-2686-8858
0000-0002-2405-4332
0000-0002-6114-8629
Journal: Perfusion
Start page: 2676591231221715
PubMed URL: 38085647
ISSN: 1477-111X
Type: Journal Article
Subjects: blood products
cardiac surgery
fresh frozen plasma
perioperative medicine
plasma
transfusion
Appears in Collections:Journal articles

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