Proactive administration of platelets and plasma for patients with a ruptured abdominal aortic aneurysm: evaluating a change in transfusion practice

• Published in: Transfusion (Philadelphia, Pa.) Pa.), 2007-04, Vol.47 (4), p.593-598
• Main Authors: Johansson, Pär I., Stensballe, Jakob, Rosenberg, Iben, Hilsløv, Tanja L., Jørgensen, Lisbeth, Secher, Niels H.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aortic Aneurysm, Abdominal - mortality; Aortic Aneurysm, Abdominal - surgery; Aortic Aneurysm, Abdominal - therapy; Biological and medical sciences; Blood coagulation. Blood cells; Blood Platelets; Blood Transfusion - methods; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Female; Fundamental and applied biological sciences. Psychology; Humans; Intensive care medicine; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Molecular and cellular biology; Partial Thromboplastin Time; Plasma; Platelet; Platelet Count; Platelet Transfusion - methods; Postoperative Care; Prothrombin Time; Survival Rate; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Treatment Outcome
• ISSN: 0041-1132; 1537-2995
• DOI: 10.1111/j.1537-2995.2007.01160.x

BACKGROUND: Continued hemorrhage remains a major contributor of mortality in massively transfused patients and those who survive have a higher platelet (PLT) count and a shorter prothrombin time and activated partial thromboplastin time (APTT) than nonsurvivors. It was considered that early substitution with PLTs and fresh‐frozen plasma (FFP) would prevent development of coagulopathy and thus improve survival. STUDY DESIGN AND METHODS: Survival of patients undergoing surgery for a ruptured abdominal aortic aneurysm (rAAA) was compared after implementing a proactive transfusion therapy encompassing two pooled buffy‐coat PLT concentrates (PBPCs) immediately when a rupture of the aorta was suspected and again 30 minutes before aortic unclamping together with FFP administered in a 1:1 ratio to the amount of red blood cells (RBCs) with that of a control group receiving transfusion therapy according to existing recommendations. RESULTS: The intervention group (n = 50) had a higher PLT count at arrival at the intensive care unit compared to the control group (n = 82; 155 × 109/L vs. 69 × 109/L; p