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Effects of platelet-rich plasmapheresis during cardiovascular surgery: A meta-analysis of randomized controlled clinical trials.
Zhai, Qing; Wang, Yun; Yuan, Zhiguo; Zhang, Rongwei; Tian, Ayong.
Afiliação
  • Zhai Q; Department of Anesthesiology, the First Affiliated Hospital of China Medical University (CMU), Shenyang, Liaoning, China.
  • Wang Y; Department of Anesthesiology, the First Affiliated Hospital of China Medical University (CMU), Shenyang, Liaoning, China.
  • Yuan Z; Department of Anesthesiology, the First Affiliated Hospital of China Medical University (CMU), Shenyang, Liaoning, China.
  • Zhang R; Department of Gerontology and Geriatrics, the First Affiliated Hospital of China Medical University (CMU), Shenyang, Liaoning, China.
  • Tian A; Department of Anesthesiology, the First Affiliated Hospital of China Medical University (CMU), Shenyang, Liaoning, China. Electronic address: tay0626@126.com.
J Clin Anesth ; 56: 88-97, 2019 Sep.
Article em En | MEDLINE | ID: mdl-30708148
ABSTRACT

OBJECTIVE:

This study aimed to explore the effects of platelet-rich plasmapheresis (PRP) on the amount of postoperative blood loss and the requirements for allogeneic fresh frozen plasma (FFP) and red blood cell (RBC) transfusions during cardiovascular surgery.

METHODS:

A literature search of 7 online databases was conducted. Randomized control trials (RCT) comparing intraoperative PRP or appropriate control groups were considered suitable for this current study.

RESULTS:

Fifteen RCTs enrolling a total of 1002 patients, including 501 patients who received PRP and 501 control patients. Meta-analysis of the data from these trials showed that PRP reduced the total volume of postoperative blood loss (standardized mean difference [SMD], -0.74; 95% confidence interval [CI], -1.18 to -0.31; P < 0.05), reduced postoperative fresh frozen plasma (FFP) transfusion (SMD, -0.38; 95%CI, -0.69 to -0.08; P < 0.05), reduced postoperative RBCs transfusion (SMD, -0.44; 95%CI, -0.77 to -0.10; P < 0.05), and reduced the proportion of patients receiving postoperative allogeneic RBC transfusions (relative risk [RR], 0.44; 95%CI, 0.21-0.91, P < 0.05) during cardiovascular surgery.

CONCLUSION:

Conducting PRP before cardiopulmonary bypass (CPB) and transfusing autologous platelet-rich plasma (aPRP) after reversal of heparin could reduce postoperative blood loss, the requirements for blood products transfusion during cardiovascular surgery. A higher mean platelet count in aPRP may improve the final outcome. However, there was a high degree of undetermined heterogeneity among the analyzed trials, and larger and more precise RCTs are needed to confirm these conclusions.
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Texto completo: 1 Base de dados: MEDLINE Métodos Terapêuticos e Terapias MTCI: Terapias_biologicas / Hemoterapia Assunto principal: Ponte Cardiopulmonar / Plasmaferese / Transfusão de Plaquetas / Hemorragia Pós-Operatória / Cuidados Intraoperatórios Tipo de estudo: Clinical_trials / Etiology_studies / Systematic_reviews Idioma: En Revista: J Clin Anesth Ano de publicação: 2019 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Base de dados: MEDLINE Métodos Terapêuticos e Terapias MTCI: Terapias_biologicas / Hemoterapia Assunto principal: Ponte Cardiopulmonar / Plasmaferese / Transfusão de Plaquetas / Hemorragia Pós-Operatória / Cuidados Intraoperatórios Tipo de estudo: Clinical_trials / Etiology_studies / Systematic_reviews Idioma: En Revista: J Clin Anesth Ano de publicação: 2019 Tipo de documento: Article País de afiliação: China