Effect of perioperative different ratios of fresh frozen plasma to red blood cell on prognosis of patients receiving massive transfusion / 中华创伤杂志

ABSTRACT

Objective To retrospectively analyze the influence of perioperatively transfusing different ratios of fresh frozen plasma (FFP) to red blood cell (RBC) on prognosis of patients receiving massive transfusion.Methods From January 2010 to September 2012,139 surgical patients with transfusion of ≥ 10 RBC units within 24 hours were included in the study.Patients were categorised into three groups based on the FFP ∶ RBC scalehigh scale group (FFP ∶ RBC ＞ 1 ∶ 1,n =19),middle scale group (FFP ∶ RBC =1 ∶ 2-1 ∶ 1,n =43) and low scale group (FFP ∶ RBC ＜ 1 ∶ 2,n =77).Comparison among the groups was made in aspects of transfusion of different blood products in hospital,blood routine index before and after massive transfusion,blood coagulation index,electrolyte index,hospital stay,ICU stay,cure rate and mortality.Results FFP transfusion was the most in high scale group (2 600 ± 1 582) ml,followed by (1 390 ± 1 043) ml in middle scale group and (318 ± 342) ml in low scale group (P ＜0.05).Platelet (PLT) transfusion was more in high scale group (0-1.4 units) and middle scale group (0-1.0 units) compared with that in low scale group (0-0.0 units,P ＜ 0.05).Volume of RBC and cryoprecipitate transfused revealed no significant differences among the groups (P ＞ 0.05).Before blood transfusion prothrombin time (PT) [(20.2 ± 10.7) s] and activated partial thromboplastin time (APTT) [(57.2±45.8) s] in middle scale group were significantly prolonged than those in high scale group [(14.3 ±4.4) s and (35.3 ± 10.0) s] and low scale group[(12.5 ± 1.7) s and (31.5 ± 5.9) s] (P ＜ 0.05),but the differences were insignificant in indices of hemoglobin (Hb),PLT,international normalized ratio (INR),K +,and Ca2 + (P ＞ 0.05).After blood transfusion Hb [(106.8 ± 31.7) g/L] and Ca2+[(1.99 ± 0.24)mmol/L] in low scale group were higher than these in middle scale group [(82.5 ± 32.2) g/L and (1.76 ± 0.38) mmol/L] and in high scale group [(91.3 ± 19.1) g/L and (1.96 ±0.25) mmol/L] (P ＜0.05),but there were no significant differences in PLT,PT,INR,APTT and K+(P ＞ 0.05).Moreover,hospital stay,ICU stay,cure rate and mortality were not differed significantly among the groups (P ＞ 0.05).Conclusion For massive transfusion patients,transfusion of FFP and RBC at a 1 ∶ 2 to 1 ∶ 1 ratio is beneficial to preventing coagulation dysfunction and reducing plasma total infusion volume,and exerts no effect on the prognosis.