The role of prophylactic fresh frozen plasma in decreasing blood loss and correcting coagulopathy in cardiac surgery. A systematic review

Authors

  • A. C. Casbard,

    1.  Medical Statistician, Medical Research Council Clinical Trials Unit, 222 Euston Road, London, UK
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  • L. M. Williamson,

    1.  Lecturer in Transfusion Medicine
    2.  Consultant in Transfusion Medicine, University of Cambridge, National Blood Service, Long Road, Cambridge, UK
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  • M. F. Murphy,

    1.  Consultant Haematologist, National Blood Service, John Radcliffe Hospital, Headington, Oxford, UK
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  • K. Rege,

    1.  Consultant Haematologist, Papworth Hospital, Papworth, Everard, Cambridgeshire, UK
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  • T. Johnson

    1.  Medical Statistician, Medical Research Council Clinical Trials Unit, 222 Euston Road, London, UK
    2.  Senior Statistician, Medical Research Council Biostatistics Unit, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge, UK
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A. C. Casbard
E-mail: acc@ctu.mrc.ac.uk

Summary

Fresh frozen plasma is commonly used in cardiac surgery in an attempt to replace clotting factors and to decrease bleeding. Despite this, there has been no previous review of the available literature to support this practice. The aim of this review was to study the effect of prophylactic peri-operative transfusion of fresh frozen plasma on bleeding and coagulopathy in patients undergoing cardiac surgery. A comprehensive literature search was performed and all randomised controlled trials of the use of fresh frozen plasma in cardiac surgery were included. Six small trials were found that included a total of 363 participants with six different dose regimens of fresh frozen plasma. The overall quality of the studies was poor due to small patient numbers and lack of allocation concealment. There was no evidence that the prophylactic use of fresh frozen plasma affected peri-operative blood loss in cardiac surgery. There was some evidence that it may improve platelet count and fibrinogen concentration.

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