Is Transfusion of Fresh Plasma After Cardiac Operations Indicated?

Abstract

Patients undergoing cardiac operations constitute the majority of recipients of fresh frozen plasma. In most centers the reason for transfusing fresh frozen plasma is to replace clotting factors. However, the decrease of clotting factors during cardiopulmonary bypass is not sufficient in most patients to cause abnormal bleeding. One of the major causes of nonsurgical bleeding after cardiac operations is acquired platelet dysfunction, which can be corrected by transfusion of 1 unit of fresh whole blood. Because plasmatic factors in fresh whole blood may be responsible for this improvement, a study was designated to evaluate the effect of transfusing fresh plasma on platelet function after cardiac operations. Forty patients undergoing cardiopulmonary bypass were randomized to receive either fresh plasma or the fresh packed cell fraction. Administration of packed cells increased platelet number (118 ± 8.5 to 154 ± 7.6 × 109/L, p