Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery: a prospective, single-blinded, randomised study

TY - JOUR

T1 - Administration of platelets to ruptured abdominal aortic aneurysm patients before open surgery

T2 - 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

N1 - © 2018 British Blood Transfusion Society.

PY - 2018/10

Y1 - 2018/10

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.

AB - 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.

KW - Aged

KW - Aortic Aneurysm, Abdominal/mortality

KW - Aortic Rupture/mortality

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Platelet Transfusion

KW - Postoperative Complications

KW - Prospective Studies

KW - Vascular Surgical Procedures/mortality

U2 - 10.1111/tme.12540

DO - 10.1111/tme.12540

M3 - Journal article

C2 - 29781549

SN - 0958-7578

VL - 28

SP - 386

EP - 391

JO - Transfusion Medicine

JF - Transfusion Medicine

IS - 5

ER -