Reduction of Fresh Frozen Plasma Requirements by Perioperative Point-of-Care Coagulation Management with Early Calculated Goal-Directed Therapy.

摘要: Summary Background: Massive bleeding and transfusion of packed red blood cells (PRBC), fresh frozen plasma (FFP) platelets are associated with increased morbidity, mortality costs. Patients Methods: We analysed the requirements after implementation point-of-care (POC) coagulation management algorithms based on early, calculated, goal-directed therapy fibrinogen concentrate prothrombin complex (PCC) in different perioperative settings (trauma surgery, visceral transplant surgery (VTS), cardiovascular (CVS) general surgical intensive care medicine) at 3 hospitals (AUVA Trauma Centre Salzburg, University Hospital Innsbruck Essen) 2 countries (Austria Germany). Results: In all institutions, POC was a reduction for FFP by about 90% (Salzburg 94%, 88% Essen 93%). Furthermore, PRBC reduced 8.4–62%. The incidence intraoperative massive (≥10 U PRBC) could be more than halved VTS CVS (2.56 vs. 0.88%; p < 0.0001 2.50 1.06%; = 0.0007, respectively). Platelet 21–72%, except where it 115% due to 5-fold increase patients dual antiplatelet (2.7 13.7%; 0.0001). Conclusions: goaldirected PCC is FFP, as well transfusion. Thus, limited resources can used efficiently. Schlusselworter