Cardiothoracic & vascular anesthesia
Factor Eight Inhibitor Bypassing Activity as First-line Therapy for Coagulopathy in Cardiac Surgery
Authors' conclusion
In the initial treatment of postcardiopulmonary bypass coagulopathy, FEIBA may be more effective than FFP in decreasing blood product transfusions and readmission rates.
Study context
- Population
- Patients undergoing noncoronary cardiac surgery with CPB, single tertiary hospital, 2015–2023cases analysed
- Participants
- 434 patients
- Exposure
- Factor eight inhibitor bypassing activity (FEIBA) vs fresh frozen plasma (FFP) as first-line treatment of post-CPB coagulopathy
- FEIBAn = 237
- FFPn = 197reference
- Outcome
- Proportion requiring packed RBC transfusion
Methodological detailspropensity-matched, single-centre
- Propensity-matched
- Single-centre
Main finding
As reported in the abstract
- FEIBA vs FFP: P = 0.08
- After propensity matching
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Units of packed RBC among those transfusedSignificantly fewer units with FEIBA | P < 0.001 |
| Platelet transfusionSignificantly fewer patients with FEIBA | P < 0.001 |
| Cryoprecipitate transfusionSignificantly fewer patients with FEIBA | P < 0.001 |
| Prolonged postoperative intubationDecreased with FEIBA | P = 0.05 |
| ICU LOSDecreased with FEIBA | P = 0.04 |
| Readmission · 30-dayLower with FEIBA | P = 0.03 |
Safety
Thrombotic complications
- No differences between the 2 cohorts
Original publication
Factor Eight Inhibitor Bypassing Activity as First-line Therapy for Coagulopathy in Cardiac Surgery. J Cardiothorac Vasc Anesth. Published 17 May 2024. doi:10.
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