Effects of platelet-rich plasmapheresis during cardiovascular surgery: A meta-analysis of randomized controlled clinical trials.
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; Pâ¯<â¯0.05), reduced postoperative fresh frozen plasma (FFP) transfusion (SMD, -0.38; 95%CI, -0.69 to -0.08; Pâ¯<â¯0.05), reduced postoperative RBCs transfusion (SMD, -0.44; 95%CI, -0.77 to -0.10; Pâ¯<â¯0.05), and reduced the proportion of patients receiving postoperative allogeneic RBC transfusions (relative risk [RR], 0.44; 95%CI, 0.21-0.91, Pâ¯<â¯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.Palavras-chave
Texto completo:
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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