title: Routine transfusion of platelet concentrates effectively reduces reoperation rate for bleeding and pericardial effusion after elective operations for ascending aortic aneurysm.
abstract: Patients with ascending aortic aneurysm undergoing complex surgical procedures are at increased risk of early postoperative excessive blood loss. The aim of this study was to analyze safety and efficacy of routine transfusions of platelet (PLT) concentrates in reduction of hemorrhagic postoperative complications. The study involved 396 consecutive patients (289 males and 107 females) with the mean age of 55.9 ± 13.6 years who underwent elective operations for aortic aneurysms. They were divided retrospectively into two groups, without (group A; n = 123) or with the routine use of PLTs (group B; n = 273). PLTs were transfused intraoperatively just after completion of cardiopulmonary bypass. Twelve patients in group A (9.8%) and 10 (3.7%) in group B required re-thoracotomy due to hemorrhage (p = 0.027). Routine transfusions of PLT concentrates reduced postoperative incidence of excessive pericardial effusion from 24.1% in group A to 2.1% in group B (p = 0.002). In a consequence, significantly less units (p < 0.0001) of red blood concentrates and fresh frozen plasma were transfused in group B than in group A. The rates of other adverse events in the early postoperative period did not differ between groups. Patients with pericardial effusion required 6.3 ± 2.7 additional days of hospitalization due to surgical re-intervention. Neither blood transfusion-related infections nor adverse reactions were noted. In conclusion, routine intraoperative transfusions of PLT concentrates in patients with ascending aortic aneurysms significantly reduced a need for re-intervention due to both early bleeding and late cardiac tamponade.
authors.affiliation: a Department of Cardiac Surgery and Transplantology , Poznań University of Medical Sciences , Poznań , Poland.
authors.forename: Bartłomiej
authors.initials: B
authors.lastname: Perek
authors.affiliation: a Department of Cardiac Surgery and Transplantology , Poznań University of Medical Sciences , Poznań , Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Stefaniak
authors.affiliation: b Ist Department of Cardiology , Poznań University of Medical Sciences , Poznań , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Komosa
authors.affiliation: c Department of Anesthesiology and Intensive Therapy , Poznań University of Medical Sciences , Poznań , Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Perek
authors.affiliation: a Department of Cardiac Surgery and Transplantology , Poznań University of Medical Sciences , Poznań , Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Katyńska
authors.affiliation: a Department of Cardiac Surgery and Transplantology , Poznań University of Medical Sciences , Poznań , Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Jemielity
mesh_terms: D000328:Adult; D000368:Aged; D001014:Aortic Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control*; D010979:Platelet Function Tests; D017713:Platelet Transfusion; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011379:Prognosis; D019233:Retreatment; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Adverse events; ascending aortic aneurysm; cost analysis; outcomes; postoperative pericardial effusion; surgery