Cardiothoracic & vascular anesthesia
Activated 4-Factor Prothrombin Complex Concentrate as a Hemostatic Adjunct for Neonatal Cardiac Surgery: A Propensity Score-Matched Cohort Study
Authors' conclusion
We found that the use of a4FPCC as a hemostatic adjunct for post-CPB bleeding in neonatal cardiac surgery was associated with a decrease in mean total blood products transfused after CPB without an increased rate of 7- or 30-day postoperative thromboembolism.
Study context
- Population
- Neonates undergoing open heart surgery with first-time sternotomy, May 2014–December 201886 propensity score matched (PSM) matched pairs: 43 vs 43
- Participants
- 165 neonates
- Exposure
- a4FPCC after cardiopulmonary bypass (CPB) vs no a4FPCC
- a4FPCCn = 43
- Controln = 43reference
- Outcome
- Total volume (mL/kg) of blood products transfused after CPB, including the first 24 hours in the cardiovascular intensive care unit (CVICU)
Methodological detailspropensity score-matched, single-centre
- Propensity score-matched
- Single-centre
Main finding
Mean total blood products transfused
Adjusted difference
15.3
95% CI 29.4–1.3
P = 0.032
By group
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
ICU LOS
adjusted P = .049
Hospital LOS
adjusted P = .049
Chest tube output, time to extubation, acute kidney injury (AKI), 30-day mortality
- No statistically significant difference between the groups
Safety
Postoperative thromboembolism (primary safety outcome) · 7 and 30 days
- No statistically significant difference in 7- or 30-day thromboembolic rate
Original publication
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