Correcting prolonged bleeding during renal transplantation with estrogen or plasma.
Arch Surg
; 131(2): 160-5, 1996 Feb.
Article
em En
| MEDLINE
| ID: mdl-8611072
ABSTRACT
OBJECTIVE:
To determine the efficacy and relative effectiveness of conjugated entrogens (CE) and fresh-frozen plasma (FFP) in normalizing prolonged preoperative bleeding times during renal transplantation.DESIGN:
Prospective, randomized trial.SETTING:
A university regional referral center for transplantation. PATIENTS Patients scheduled for renal transplantation with preoperative bleeding times greater than 10 minutes (normal, < 7 minutes) following informed consent were asked to participate in the randomized protocol. Those with bleeding times of 8 to 9.5 minutes were asked, following informed consent, to be a control group receiving neither CE nor FFP.INTERVENTIONS:
Following induction of anesthesia and drawing of baseline laboratory tests, patients were administered randomly, using a table of random numbers, either 50 mg of CE or 2 U of FFP. MAIN OUTCOMEMEASURES:
Bleeding time measurements and other laboratory tests were repeated at the end of surgery as well as at 24 and 48 hours postoperatively.RESULTS:
Treatment with CE and FFP decreased the patients' bleeding times from 16.68 +/- 0.8 (SEM) and 17.13 +/- 0.85 minutes to 7.67 +/- 0.79 (P < .001) and 10.50 +/- 1.27 minutes (P < .001), respectively, by the end of surgery. At 24 and 48 hours postoperatively, the CE group had bleeding times of 9.77 +/- 0.99 and 9.81 +/- 1.24 minutes (P < .001 for both), respectively, whereas the FFP group bleeding times were 12.76 +/- 1.57 (P = .003) and 12.14 +/- 1.56 minutes (P = .001), respectively. There were no statistical differences for the control group compared with baseline either at the end of surgery or at 24 hours.CONCLUSIONS:
Although both CE and FFP significantly decreased prolonged preoperative bleeding times during renal transplantation, CE might be preferred because of lower risk and cost, as well as a longer duration of action.
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Base de dados:
MEDLINE
Assunto principal:
Plasma
/
Transtornos da Coagulação Sanguínea
/
Coagulantes
/
Transplante de Rim
/
Estrogênios Conjugados (USP)
Idioma:
En
Ano de publicação:
1996
Tipo de documento:
Article