Effects of autologous platelet-rich plasma on postoperative outcomes in patients undergoing Sun′s procedure

Wen-Zhi Tian ,Jianxu Er ,Liang Liu ,Qingliang Chen ,Jian Han

doi:10.3760/cma.j.issn.0254-1416.2019.10.017

Wen-Zhi Tian , Jianxu Er + Show 3 more

https://doi.org/10.3760/cma.j.issn.0254-1416.2019.10.017

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Objective To evaluate the effect of autologous platelet-rich plasma (aPRP) on postoperative outcomes in the patients undergoing Sun′s procedure. Methods One hundred and sixteen patients with acute Stanford type A aortic dissection of both sexes, aged 18-64 yr, with body mass index of 19-34 kg/m2, of American Society of Anesthesiologist physical status Ⅳ, were divided into aPRP group (group A) and control group (group C) by a random number table method, with 58 cases in each group.After anesthesia induction and intubation, aPRP preparation was completed before surgery in group A, and surgery began in group C. After heparin neutralization, group A received retransfusion of platelet-rich plasma, while group C received conventional fluid management.Thromboelastography was performed on all patients, and the results were recorded.The intraoperative amount of allogeneic blood products and blood loss were recorded in two groups.Plasma concentrations of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were recorded after anesthesia induction (T0), immediately after completion of aPRP preparation (T1), 3 h after heparin neutralization (T2), and at 24 and 48 h after surgery (T3, 4). The volume of postoperative chest drainage and amount of allogeneic blood products, mechanical ventilation time, lengths of intensive care unit and hospital stay, incidence of important complications and fatality rate within 30 days after surgery were also collected. Results Compared with group C, the intraoperative amount of allogeneic blood products and blood loss were significantly reduced, α angle and MA values of thromboelastograph were larger, plasma concentrations of TNF-α and IL-6 were reduced at T2, 3, postoperative chest drainage volume and allogeneic blood transfusion were reduced, the postoperative mechanical ventilation time and length of hospital stay were shortened, and the incidence of pulmonary complications was reduced in group A(P 0.05). Conclusion aPRP can improve postoperative outcomes in the patients undergoing Sun′s procedure. Key words: Platelet-rich plasma; Aneurysm, dissecting; Prognosis

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