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The use of cryopreserved platelets in the treatment of polytraumatic patients and patients with massive bleeding

M. Bohonek, D. Kutac, L. Landova, M. Koranova, E. Sladkova, E. Staskova, M. Voldrich, T. Tyll,

. 2019 ; 59 (S2) : 1474-1478. [pub] -

Jazyk angličtina Země Spojené státy americké

Typ dokumentu klinické zkoušky, srovnávací studie, časopisecké články, pozorovací studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc19034633

BACKGROUND: The short shelf-life of fresh platelets limits their efficient inventory management and availability during a massive transfusion protocol. Risk of insufficient availability can be mitigated by building an inventory of cryopreserved platelets (CPs). METHODS: A comparative study of fresh apheresis platelets (FAPs) and CPs was performed. Type-O CPs were processed with DMSO frozen at -80°C and reconstituted in thawed AB plasma. All patients enrolled in the study had the following parameters evaluated on admission: vital signs (body temperature, heart rate, mean arterial pressure), blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level, and, in trauma patients, international severity score. Several outcomes were evaluated: 30-day survival, adverse events, quantity of administered blood products, fibrinogen concentrate and thromboxane (TXA), and laboratory parameters after transfusion (blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level). RESULTS: Twenty-five (25) patients in the study group received transfusions totaling 81 units of CPs. Twenty-one (21) patients in the control group received a total of 67 units of FAPs. There were no significant differences in patient characteristics (p > 0.05) between groups. Both groups were comparable in clinical outcomes (30-day survival, administered blood products, fibrinogen concentrate, TXA, and adverse events). Among posttransfusion laboratory parameters, platelet count was higher in the group transfused with FAPs (97.0 ×109 /L) than in the group transfused with CPs (41.5 ×109 /L), p = 0.02025. Other parameters were comparable in both groups. CONCLUSION: The study suggests that CPs are tolerable and a feasible alternative to FAPs. However, larger randomized studies are needed to draw definitive conclusions.

Citace poskytuje Crossref.org

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$a BACKGROUND: The short shelf-life of fresh platelets limits their efficient inventory management and availability during a massive transfusion protocol. Risk of insufficient availability can be mitigated by building an inventory of cryopreserved platelets (CPs). METHODS: A comparative study of fresh apheresis platelets (FAPs) and CPs was performed. Type-O CPs were processed with DMSO frozen at -80°C and reconstituted in thawed AB plasma. All patients enrolled in the study had the following parameters evaluated on admission: vital signs (body temperature, heart rate, mean arterial pressure), blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level, and, in trauma patients, international severity score. Several outcomes were evaluated: 30-day survival, adverse events, quantity of administered blood products, fibrinogen concentrate and thromboxane (TXA), and laboratory parameters after transfusion (blood count, prothrombin time, activated partial thromboplastin time, fibrinogen level). RESULTS: Twenty-five (25) patients in the study group received transfusions totaling 81 units of CPs. Twenty-one (21) patients in the control group received a total of 67 units of FAPs. There were no significant differences in patient characteristics (p > 0.05) between groups. Both groups were comparable in clinical outcomes (30-day survival, administered blood products, fibrinogen concentrate, TXA, and adverse events). Among posttransfusion laboratory parameters, platelet count was higher in the group transfused with FAPs (97.0 ×109 /L) than in the group transfused with CPs (41.5 ×109 /L), p = 0.02025. Other parameters were comparable in both groups. CONCLUSION: The study suggests that CPs are tolerable and a feasible alternative to FAPs. However, larger randomized studies are needed to draw definitive conclusions.
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$a Kutac, Dominik $u Department of Haematology and Blood Transfusion, Military University Hospital Prague, Prague, Czech Republic. Faculty of Military Health Sciences, University of Defence Hradec Kralove, Hradec Kralove, Czech Republic.
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$a Landova, Ludmila $u Department of Haematology and Blood Transfusion, Military University Hospital Prague, Prague, Czech Republic.
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$a Koranova, Michaela $u Department of Haematology and Blood Transfusion, Military University Hospital Prague, Prague, Czech Republic.
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$a Sladkova, Eliska $u Department of Haematology and Blood Transfusion, Military University Hospital Prague, Prague, Czech Republic.
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$a Staskova, Eva $u Department of Haematology and Blood Transfusion, Military University Hospital Prague, Prague, Czech Republic.
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$a Voldrich, Martin $u Department of Anesthesiology and Intensive Care Medicine, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czech Republic.
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$a Tyll, Tomas $u Department of Anesthesiology and Intensive Care Medicine, First Faculty of Medicine, Charles University and Military University Hospital Prague, Prague, Czech Republic.
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