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Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery: a prospective, single-blinded, randomised study.
Transfus Med. 2018 Oct; 28(5):386-391.TM

Abstract

BACKGROUND

In patients undergoing open surgery for a ruptured abdominal aortic aneurysm (rAAA), survivors demonstrate a high platelet count, and proactive administration of platelets (and fresh frozen plasma) appears to influence mortality.

OBJECTIVES

This trial investigated the effect of platelets administered before transport to surgery.

METHODS

In a prospective study design, patients were randomised to receive platelets (intervention; n = 61) or no platelets (control; n = 61) before transport to vascular surgery from 11 local hospitals. The study was terminated when one of the vascular surgical centres implemented endovascular repair for rAAA patients.

RESULTS

Thirty days after surgery, mortality was 36% for patients with intervention vs 31% for controls (P = 0·32). Post-operative thrombotic events (14 vs 15; P = 0·69), renal failure (11 vs 10; P = 0·15) and pulmonary insufficiency (34 vs 39; P = 0·15) were similar in the two groups of patients. No adverse reactions to platelet administration were observed. In addition, length of stay in the intensive care unit was unaffected by intervention.

CONCLUSIONS

For patients planned for open repair of a rAAA, we observed no significant effect of early administration of platelets with regard to post-operative complications and stay in the ICU or in hospital and also no significant effect on mortality.

Authors+Show Affiliations

Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Department of Anesthesiology, SUH Zealand University Hospital Koege, Region Zealand, Denmark.Department of Transfusion Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Department of Surgery, University of Texas Health Medical School, Houston, Texas, USA.Department of Anesthesiology, SUH Zealand University Hospital Koege, Region Zealand, Denmark. Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Clinical Immunology, Naestved Sygehus, Naestved, Denmark.Department of Vascular Surgery, Odense University Hospital, Odense, Denmark.Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Department of Radiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Vascular Surgery, Region Zealand, Slagelse Hospital, Slagelse, Denmark.Department of Statistics, Panum Institutet, University of Copenhagen, Copenhagen, Denmark.Department of Statistics, Panum Institutet, University of Copenhagen, Copenhagen, Denmark. Center for Statistical Science, Peking University, Beijing, China.Department of Vascular Surgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Anesthesiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Sanos as, Sanos Clinic, Herlev, Denmark.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

29781549

Citation

Lunen, T B., et al. "Administration of Platelets to Ruptured Abdominal Aortic Aneurysm Patients Before Open Surgery: a Prospective, Single-blinded, Randomised Study." Transfusion Medicine (Oxford, England), vol. 28, no. 5, 2018, pp. 386-391.
Lunen TB, Johansson PI, Jensen LP, et al. Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery: a prospective, single-blinded, randomised study. Transfus Med. 2018;28(5):386-391.
Lunen, T. B., Johansson, P. I., Jensen, L. P., Homburg, K. M., Roeder, O. C., Lonn, L., Secher, N. H., Helgstrand, U., Carstensen, M., Jensen, K. B., Lange, T., Sillesen, H., Swiatek, F., & Nielsen, H. B. (2018). Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery: a prospective, single-blinded, randomised study. Transfusion Medicine (Oxford, England), 28(5), 386-391. https://doi.org/10.1111/tme.12540
Lunen TB, et al. Administration of Platelets to Ruptured Abdominal Aortic Aneurysm Patients Before Open Surgery: a Prospective, Single-blinded, Randomised Study. Transfus Med. 2018;28(5):386-391. PubMed PMID: 29781549.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery: a prospective, single-blinded, randomised study. AU - Lunen,T B, AU - Johansson,P I, AU - Jensen,L P, AU - Homburg,K M, AU - Roeder,O C, AU - Lonn,L, AU - Secher,N H, AU - Helgstrand,U, AU - Carstensen,M, AU - Jensen,K B, AU - Lange,T, AU - Sillesen,H, AU - Swiatek,F, AU - Nielsen,H B, Y1 - 2018/05/21/ PY - 2018/01/15/received PY - 2018/04/20/revised PY - 2018/04/20/accepted PY - 2018/5/22/pubmed PY - 2018/12/14/medline PY - 2018/5/22/entrez KW - haemorrhage KW - open repair KW - platelets KW - rAAA KW - ruptured abdominal aortic aneurysm KW - survival SP - 386 EP - 391 JF - Transfusion medicine (Oxford, England) JO - Transfus Med VL - 28 IS - 5 N2 - BACKGROUND: In patients undergoing open surgery for a ruptured abdominal aortic aneurysm (rAAA), survivors demonstrate a high platelet count, and proactive administration of platelets (and fresh frozen plasma) appears to influence mortality. OBJECTIVES: This trial investigated the effect of platelets administered before transport to surgery. METHODS: In a prospective study design, patients were randomised to receive platelets (intervention; n = 61) or no platelets (control; n = 61) before transport to vascular surgery from 11 local hospitals. The study was terminated when one of the vascular surgical centres implemented endovascular repair for rAAA patients. RESULTS: Thirty days after surgery, mortality was 36% for patients with intervention vs 31% for controls (P = 0·32). Post-operative thrombotic events (14 vs 15; P = 0·69), renal failure (11 vs 10; P = 0·15) and pulmonary insufficiency (34 vs 39; P = 0·15) were similar in the two groups of patients. No adverse reactions to platelet administration were observed. In addition, length of stay in the intensive care unit was unaffected by intervention. CONCLUSIONS: For patients planned for open repair of a rAAA, we observed no significant effect of early administration of platelets with regard to post-operative complications and stay in the ICU or in hospital and also no significant effect on mortality. SN - 1365-3148 UR - https://www.unboundmedicine.com/medline/citation/29781549/Administration_of_platelets_to_ruptured_abdominal_aortic_aneurysm_patients_before_open_surgery:_a_prospective_single_blinded_randomised_study_ L2 - https://doi.org/10.1111/tme.12540 DB - PRIME DP - Unbound Medicine ER -