Intraoperative fresh-frozen plasma versus human albumin in craniofacial surgery − A pilot study comparing coagulation profiles in infants younger than 12 months

2007 ◽  
Vol 98 (07) ◽  
pp. 172-177 ◽  
Author(s):  
Andreas Machotta ◽  
Hanno Riess ◽  
Sabine Kerner ◽  
Olaf Ahlers ◽  
Hannes Haberl ◽  
...  
Keyword(s):  
Pilot Study ◽  
Activation Parameters ◽  
Human Albumin ◽  
Fresh Frozen Plasma ◽  
Craniofacial Surgery ◽  
Volume Replacement ◽  
Postoperative Blood Loss ◽  
Clinical Endpoints ◽  
Fresh Frozen ◽  
Frozen Plasma

SummaryThe transfusion of fresh-frozen plasma (FFP) is suggested to minimize dilution coagulopathy when applied instead of colloids during paediatric craniofacial surgery (pCFS). We prospectively compared plasmatic haemostaseologic function between volume replacement with FFPs versus human albumin (HA) in a pilot study. Thirty infants with primary craniosynostosis were scheduled for pCFS. In 15 of those, FFPs were available from the identical donor as for packed red blood cells (pRBC), and were thus employed for intraoperative volume replacement. The remaining 15 infants were infused with HA-5% instead. Haemoglobin (Hb)-values, global coagulation parameters (activated partial thromboplastin time-aPTT; prothrombin time-PT), selected clotting factors (F) (VIII, XI, XIII), antithrombin-AT, fibrinolytic factors (fibrinogen; plasminogen; alpha2-antiplasmin-α2A), and activation parameters (thrombin-antithrombin-complex-TAT; plasmin-antiplasmin-complex-PAP; D-dimers) were assessed and compared between both groups after induction of anaesthesia, before transfusion of pRBC, and at the end of surgery. Patients and treatment characteristics were balanced between both groups. Prolongation of aPTT and decreases of PT, FXI, FXIII, AT3, and fibrinolytic factors were more pronounced in the HA-group. Increases in F VIII activity, activation parameters, and the course of Hb-values were similar among both groups. There was no difference regarding clinical endpoints (peri-/postoperative pRBC-transfusions, postoperative blood loss). In conclusion, the application of HA was associated with a more distinct dilution of procoagulant factors, AT3, and fibrinolytic factors than the use of FFPs. However, the course of activation markers suggested a similar extent of clotting and fibrinolytic activation with the use of both transfusion regimens, and there were no differences with regard to clinical endpoints.

A Clinical Pilot Study of Fresh Frozen Plasma versus Human Albumin in Paediatric Craniofacial Repair

2008 ◽  
Vol 36 (1) ◽  
pp. 171-177 ◽  
Author(s):  
T Kerner ◽  
A Machotta ◽  
S Kerner ◽  
O Ahlers ◽  
H Haberl ◽  
...  
Keyword(s):  
Pilot Study ◽  
Human Albumin ◽  
Fresh Frozen Plasma ◽  
Fresh Frozen ◽  
Frozen Plasma

scholarly journals Fresh Frozen Plasma versus Crystalloid Priming of Cardiopulmonary Bypass Circuit in Pediatric Surgery

2020 ◽  
Vol 132 (1) ◽  
pp. 95-106 ◽  
Author(s):  
Audrey Dieu ◽  
Maria Rosal Martins ◽  
Stephane Eeckhoudt ◽  
Amine Matta ◽  
David Kahn ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Postoperative Bleeding ◽  
Fresh Frozen Plasma ◽  
Postoperative Blood Loss ◽  
Blood Product Transfusion ◽  
Blood Products ◽  
Packed Red Blood Cells ◽  
Number Of Patients ◽  
Fresh Frozen ◽  
Frozen Plasma

Abstract Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New Background In congenital cardiac surgery, priming cardiopulmonary bypass (CPB) with fresh frozen plasma (FFP) is performed to prevent coagulation abnormalities. The hypothesis was that CPB priming with crystalloids would be different compared with FFP in terms of bleeding and/or need for blood product transfusion. Methods In this parallel-arm double-blinded study, patients weighing between 7 and 15 kg were randomly assigned to a CPB priming with 15 ml · kg−1 PlasmaLyte or 15 ml · kg−1 FFP in addition to a predefined amount of packed red blood cells used in all patients. The decision to transfuse was clinical and guided by point-of-care tests. The primary endpoints included postoperative bleeding tracked by chest tubes, number of patients transfused with any additional blood products, and the total number of additional blood products administered intra- and postoperatively. The postoperative period included the first 6 h after intensive care unit arrival. Results Respectively, 30 and 29 patients in the FFP and in the crystalloid group were analyzed in an intention-to-treat basis. Median postoperative blood loss was 7.1 ml · kg−1 (5.1, 9.4) in the FFP group and 5.7 ml · kg−1 (3.8, 8.5) in the crystalloid group (P = 0.219); difference (95% CI): 1.2 (−0.7 to 3.2). The proportion of patients additionally transfused was 26.7% (8 of 30) and 37.9% (11 of 29) in the FFP and the crystalloid groups, respectively (P = 0.355; odds ratio [95% CI], 1.7 [0.6 to 5.1]). The median number of any blood products transfused in addition to priming was 0 (0, 1) and 0 (0, 2) in the FFP and crystalloid groups, respectively (P = 0.254; difference [95% CI], 0 [0 to 0]). There were no study-related adverse events. Conclusions The results demonstrate that in infants and children, priming CPB with crystalloids does not result in a different risk of postoperative bleeding and need for transfusion of allogeneic blood products.

Thromboelastography: a promising alternative to monitor fresh frozen plasma transfusion. A pilot Study in ICU patients

2020 ◽  
Vol 15 (2) ◽  
pp. 292-299
Author(s):  
Ajay Singh Praveen ◽  
Ravneet Kaur Bedi ◽  
Satinder Gombar ◽  
Anshu Palta
Keyword(s):  
Pilot Study ◽  
Fresh Frozen Plasma ◽  
Plasma Transfusion ◽  
Icu Patients ◽  
Promising Alternative ◽  
Fresh Frozen ◽  
Frozen Plasma

scholarly journals Hypoalbuminemia in critically sick children

2019 ◽  
Vol 6 (3) ◽  
pp. 922
Author(s):  
Sandeep T. Golhar ◽  
Hina Agrawal ◽  
Urmila M. Chauhan ◽  
Abhishek Madhura
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Serum Albumin ◽  
Paediatric Intensive Care Unit ◽  
Human Albumin ◽  
Fresh Frozen Plasma ◽  
Paediatric Intensive Care ◽  
Common Finding ◽  
Fresh Frozen ◽  
Frozen Plasma

Background: Hypoalbuminemia at admission is a common finding in patients admitted to the Paediatric Intensive Care Unit (PICU) and may predict morbidity and mortality.Methods: Patients of age more than 1 year and less than 12 years diagnosed with hypoalbuminemia on the grounds of the inclusion criteria who were admitted in the Paediatric Intensive Care Unit (PICU) were enrolled in the study as ‘cases’ and patients with normal levels of serum albumin and otherwise similar characteristics to cases were included in the study as ‘controls’. Detailed clinical examination and required investigations were done. Above collected information was utilized to select two groups for the study i.e., those with hypoalbuminemia and others with no hypoalbuminemia. Both these groups were further followed up till discharge or death and the outcome in terms of morbidity and mortality was noted.Results: Incidences of MODS and degree of severity of illness as judged by PRISM III score in cases and control showed that, a lower serum albumin concentration correlated well with higher rates of complications such as ventilator dependence and development of new infections leading longer stay in the critical care unit. The mean length of PICU stay in cases group was statistically longer than in the control group. Although we did not observe a difference in fatal outcome in patients managed with either Human Albumin or Fresh Frozen Plasma compared to those managed conservatively in this study, we did observe a decreased mean length of PICU stay and rate of complications in the patients treated with either Human Albumin or Fresh Frozen Plasma, thus achieving a faster rate of recovery with lesser rate of complications and thus alleviating the morbidity, though still not being able to affect the overall mortality.Conclusions: Hypoalbuminemia at admission was a predictive factor of poor outcome in critically ill children. It is associated with a higher mortality, a longer length of stay in the PICU, as well as longer ventilator use.

Binding of vanadate to human albumin in infusion solutions, to proteins in human fresh frozen plasma, and to transferrin

2002 ◽  
Vol 90 (1-2) ◽  
pp. 38-42 ◽  
Author(s):  
Günter Heinemann ◽  
Burckhard Fichtl ◽  
Matthias Mentler ◽  
Wolfgang Vogt
Keyword(s):  
Human Albumin ◽  
Fresh Frozen Plasma ◽  
Fresh Frozen ◽  
Frozen Plasma

Coagulation ability when separating from cardiopulmonary bypass with and without fresh frozen plasma: a pilot study

2020 ◽  
Vol 68 (12) ◽  
pp. 1361-1368
Author(s):  
Takahiro Tamura ◽  
Shuichi Yokota ◽  
Toshiaki Ito ◽  
Masahiko Ando ◽  
Yoko Kubo ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pilot Study ◽  
Fresh Frozen Plasma ◽  
Fresh Frozen ◽  
Frozen Plasma

Fresh Frozen Plasma versus Human Albumin in Paediatric Craniofacial Repair

2009 ◽  
Vol 37 (3) ◽  
pp. 973-974 ◽  
Author(s):  
Paul A Stricker ◽  
John E Fiadjoe ◽  
Lynne G Maxwell
Keyword(s):  
Human Albumin ◽  
Fresh Frozen Plasma ◽  
Fresh Frozen ◽  
Frozen Plasma

Das Smith-Lemli-Opitz-Syndrom

2005 ◽  
Vol 5 (04) ◽  
pp. 178-182
Author(s):  
Wieland Kiess ◽  
Manuela Schulz ◽  
Sabine Liebermann ◽  
Roland Pfäffle ◽  
Peter Bührdel ◽  
...  
Keyword(s):  
Fresh Frozen Plasma ◽  
Therapeutische Möglichkeiten ◽  
Fresh Frozen ◽  
Frozen Plasma

ZusammenfassungDas Smith-Lemli-Opitz-Syndrom wird durch einen Defekt des letzten Schrittes der Cholesterolbiosynthese, den Mangel an 7-Dehydrocholesterolreduktase, verursacht. Die Akkumulation der Metaboliten 7-Dehydrocholesterol und 8-Dehydrocholesterol, die die wichtigsten biochemischen Marker für die Diagnose der Erkrankung darstellen, sowie der Mangel an Cholesterol können zu multiplen kongenitalen Anomalien führen. Die Ursache des Enzymmangels sind Mutationen innerhalb des DHCR7-Gens, welches auf Chromosom 11q13 lokalisiert ist. Therapeutische Möglichkeiten bestehen in der Gabe von Cholesterol und im Notfall Fresh Frozen Plasma (FFP); der therapeutische Nutzen von Statinen befindet sich zurzeit in der klinischen Erprobung.

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