title: Intraoperative plasmapheresis in cardiac surgery.
abstract: OBJECTIVE
  To determine the effects of intraoperative plasmapheresis on total transfusion requirements, mediastinal drainage, and coagulation.
  
  
  METHODS
  The trial was prospective, randomized, and controlled.
  
  
  METHODS
  Inpatient cardiac surgery at a university medical center.
  
  
  METHODS
  Two hundred ninety-three consecutive patients undergoing cardiac surgery requiring cardiopulmonary bypass.
  
  
  METHODS
  Intraoperative plasmapheresis (IP) was performed in 147 patients before heparinization; platelet-rich plasma was reinfused immediately after heparin reversal.
  
  
  RESULTS
  Mediastinal chest tube drainage during the first 12 postoperative hours was significantly less in the IP group (p = 0.022), but no difference was noted in total postoperative blood loss between the two groups. The amount of packed red cells and fresh frozen plasma transfused to the IP group in the intensive care unit was significantly lower (p = 0.02, p = 0.002, respectively); 51.4% of patients required no transfusion compared with the control group (34.5%) (p = 0.006). No differences were noted for data collected in the intensive care unit in terms of the mean duration of chest tube drainage, ventilator time, or any hematologic variables at baseline or at any subsequent time in the study.
  
  
  CONCLUSIONS
  After cardiac surgery, intraoperative plasma-pheresis reduces early postoperative bleeding and decreases the need for homologous transfusions.
authors.affiliation: Department of Anesthesiology and Critical Care, University of Padova, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Armellin
authors.forename: C
authors.initials: C
authors.lastname: Sorbara
authors.forename: R
authors.initials: R
authors.lastname: Bonato
authors.forename: D
authors.initials: D
authors.lastname: Pittarello
authors.forename: P
authors.initials: P
authors.lastname: Dal Cero
authors.forename: G
authors.initials: G
authors.lastname: Giron
mesh_terms: D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D010976:Platelet Count
chemical_list: D006454:Hemoglobins