Cardiothoracic & vascular anaesthesia
The association of estimated citrate load with frozen plasma versus four-factor prothrombin complex concentrate for coagulopathy after cardiac surgery: a post hoc exploratory analysis of the FARES-II randomised controlled trial
Authors' conclusion
This exploratory, hypothesis-generating analysis demonstrated markedly higher estimated citrate exposure with FP than PCC.
Study context
- Population
- Adults with coagulopathy after cardiac surgery, 12 North American centres, 30 November 2022 to 28 May 2024
- Participants
- 420 adults · 12 centres
- Comparison
- Frozen plasma (FP) vs prothrombin complex concentrate (PCC): estimated citrate load
- FPn = 207reference
- PCCn = 213
- Primary endpoint
- Per-patient cumulative estimated citrate load
- Follow-up
- 12 and 24 h post-investigational medicinal product
Methodological detailspost hoc, exploratory, multicentre
- Post hoc
- Exploratory
- Multicentre
Primary result
As reported in the abstract
Per-patient estimated citrate load · 12-24 h
- Total estimated citrate exposure substantially higher in FP; median per-patient load approximately six-fold greater with FP
Secondary outcomes
Hourly trajectory of citrate-containing product administration
- Continued through 8 h with FP; largely confined to first 2 h with PCC
12-h chest tube drainage by quartile of estimated 12-h citrate load
- Across all quartiles, FP had higher citrate exposure and chest tube drainage; PCC highest quartile drainage similar to FP third quartile
Original publication
The association of estimated citrate load with frozen plasma versus four-factor prothrombin complex concentrate for coagulopathy after cardiac surgery: a post hoc exploratory analysis of the FARES-II randomised controlled trial. BJA Open. Published 29 June 2026. doi:10.
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