Prior administration of cryosupernatant plasma into the cardiopulmonary bypass in hypothermic thoracic aortic surgery reduced intraoperative fresh frozen plasma and postoperative red blood cell transfusion without volume overload

<p>[Purpose] Few literature reported regarding the administration of cryosupernatant plasma (CSP), an accessary product of cryoprecipitate. In this study, the effect of prior CSP administration into the cardiopulmonary bypass circuit (CPB) during thoracic aortic surgery was retrospectively investigated.</p><p>[Methods] Adult patients who used cryoprecipitate during hypothermic thoracic aortic surgery between 2010 and 2014 were enrolled and divided into two groups, group A (CSP had been administered after CPB) and group B (CSP had been administered prior to CPB). Additionally, we retrospectively investigated the plasma fibrinogen level (Fbg) during rewarming and blood transfusion.</p><p>[Results] Finally, a total of 25 patients in group A and 42 patients in group B were analyzed. In group B, Fbg during rewarming was significantly higher, and intraoperative fresh frozen plasma (FFP) and postoperative red blood cell (RBC) transfusion was lower (13.2±2.9 vs 10.3±3.0 units, P<0.001; 1.8±2.5 unit vs 0.6±1.2 unit, P<0.01). In the multiple regression analysis, Fbg during rewarming and use of CSP affected intraoperative FFP, and postoperative activated partial thromboplastin time affected postoperative RBC.</p><p>[Conclusion] Prior administration of CSP into CPB led to Fbg retention during rewarming and improvements in the postoperative coagulation function, which eventually reduced intraoperative FFP and postoperative RBC transfusion in hypothermic thoracic aortic surgery.</p>