PMID- 33189763
OWN - NLM
STAT- MEDLINE
DCOM- 20211011
LR  - 20211011
IS  - 1097-6809 (Electronic)
IS  - 0741-5214 (Print)
IS  - 0741-5214 (Linking)
VI  - 73
IP  - 4
DP  - 2021 Apr
TI  - Systematic review of plasma/packed red blood cell ratio on survival in ruptured 
      abdominal aortic aneurysms.
PG  - 1438-1444
LID - S0741-5214(20)32284-9 [pii]
LID - 10.1016/j.jvs.2020.10.027 [doi]
AB  - BACKGROUND: The ideal perioperative fluid resuscitation for patients with 
      ruptured abdominal aortic aneurysms (rAAAs) is unknown. It has been shown in 
      trauma studies that a higher ratio of plasma and platelets to packed red blood 
      cells confers a mortality benefit. Controversy remains whether this is true also 
      in the rAAA population. The objective of the present study was to investigate the 
      benefit of a greater ratio of plasma/packed red blood cells in patients with 
      rAAAs. METHODS: A health sciences librarian searched four electronic databases, 
      including PubMed, Embase, Cochrane, and ClinicalTrials.gov, using concepts for 
      the terms "fluid resuscitation," "survival," and "ruptured abdominal aortic 
      aneurysm." Two reviewers independently screened the studies that were identified 
      through the search strategy and read in full any study that was potentially 
      relevant. Studies were included if they had compared the mortality of patients 
      with rAAAs who had received a greater ratio of plasma to other component therapy 
      with that of patients who had received a lower ratio. The risk of bias was 
      assessed using the ROBINS-I (risk of bias in nonrandomized studies of 
      interventions) validated tool, and evidence quality was rated using the GRADE 
      (grades of recommendation assessment, development, and evaluation) profile. No 
      data synthesis or meta-analysis was planned or performed, given the anticipated 
      paucity of research on this topic and the high degree of heterogeneity of 
      available studies. RESULTS: Our search identified seven observational studies for 
      inclusion in the present review. Of these seven studies, three found an 
      associated decrease in mortality with a greater ratio of plasma to packed red 
      blood cells. The remaining four found no significant differences. The overall 
      risk of bias was serious, and the evidence quality was very low. CONCLUSIONS: 
      Overall, the findings from the available studies would suggest that for patients 
      who have undergone open surgery for a rAAA, mortality tends to be decreased when 
      the amount of plasma transfused perioperatively is similar to the amount of 
      packed red blood cells. However, the included studies reported very low-quality 
      evidence based solely on highly heterogeneous observational studies, and further 
      research is warranted.
CI  - Copyright (c) 2020 Society for Vascular Surgery. Published by Elsevier Inc. All 
      rights reserved.
FAU - Phillips, Amanda R
AU  - Phillips AR
AD  - Division of Vascular Surgery, Department of Surgery, University of Pittsburgh 
      Medical Center, Pittsburgh, Pa. Electronic address: phillipsar2@upmc.edu.
FAU - Tran, Lillian
AU  - Tran L
AD  - Division of Vascular Surgery, Department of Surgery, University of Pittsburgh 
      Medical Center, Pittsburgh, Pa.
FAU - Foust, Jill E
AU  - Foust JE
AD  - University of Pittsburgh, Pittsburgh, Pa.
FAU - Liang, Nathan L
AU  - Liang NL
AD  - Division of Vascular Surgery, Department of Surgery, University of Pittsburgh 
      Medical Center, Pittsburgh, Pa.
LA  - eng
GR  - T32 HL098036/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Systematic Review
DEP - 20201113
PL  - United States
TA  - J Vasc Surg
JT  - Journal of vascular surgery
JID - 8407742
SB  - IM
MH  - Aortic Aneurysm, Abdominal/diagnosis/mortality/*surgery
MH  - Aortic Rupture/diagnosis/mortality/*surgery
MH  - *Blood Component Transfusion/adverse effects/mortality
MH  - *Blood Vessel Prosthesis Implantation/adverse effects/mortality
MH  - *Endovascular Procedures/adverse effects/mortality
MH  - *Erythrocyte Transfusion/adverse effects/mortality
MH  - Humans
MH  - Observational Studies as Topic
MH  - *Plasma
MH  - Risk Assessment
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC8005448
MID - NIHMS1671147
OTO - NOTNLM
OT  - Blood transfusion ratio
OT  - Plasma
OT  - Resuscitation
OT  - Ruptured abdominal aortic aneurysm
COIS- Author conflict of interest: None
EDAT- 2020/11/16 06:00
MHDA- 2021/10/12 06:00
PMCR- 2021/04/01
CRDT- 2020/11/15 20:25
PHST- 2020/05/18 00:00 [received]
PHST- 2020/10/10 00:00 [accepted]
PHST- 2020/11/16 06:00 [pubmed]
PHST- 2021/10/12 06:00 [medline]
PHST- 2020/11/15 20:25 [entrez]
PHST- 2021/04/01 00:00 [pmc-release]
AID - S0741-5214(20)32284-9 [pii]
AID - 10.1016/j.jvs.2020.10.027 [doi]
PST - ppublish
SO  - J Vasc Surg. 2021 Apr;73(4):1438-1444. doi: 10.1016/j.jvs.2020.10.027. Epub 2020 
      Nov 13.