Original Article

Prophylactic Fresh Frozen Plasma Administration: Failure to Reduce Blood Loss or Transfusion Requirements after Routine Cardiopulmonary Bypass

Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky

^* Address all communications to: Norman Snow, M.D., Division of Cardiothoracic Surgery, Case Western Reserve University School of Medicine, Cleveland Metropolitan General Hospital, 3395 Scranton Road, Cleveland, Ohio 44109.

Received: January 1982
Accepted: May 1982

Abstract

Cardiopulmonary bypass may result in a variety of coagulation disorders, some of which result in overt hemorrhage. The routine use of blood products to normalize clotting factors in the postbypass period is expensive and may subject the patient to the risk of hepatitis and isoimmunization. We studied the effects of routine administration of four units of fresh frozen plasma (FFP) on standard clotting factors, mediastinal blood loss, and transfusion requirements in a randomized prospective fashion. Twenty-seven patients received plasma and 26 did not. There were no differences in the preoperative clotting studies, blood counts, liver functions, pump time, cross clamp time or type of surgery between the groups.

No differences were noted between the two groups in homologous blood requirements, clotting parameters or mediastinal blood loss. Patients receiving FFP had slightly lower hematocrits in the early postoperative period.

The routine use of FFP had no discernibleeffect on post-bypass hemorrhage or blood usage in a series of open heart operations, most of which were coronary revascularization. The clotting factors in the single reoperated patient were normal. Technical factors and precise heparin reversal play a more important role in postoperative hemostasis than plasma. We cannot recommend the routine administration of FFP after cardiopulmonary bypass.