***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Although fresh frozen plasma ( FFP ) is one of the most commonly used hemostatic agents in clinical specialties today , there is little evidence available supporting its administration . Our present study observed the effects of a priming strategy without FFP during cardiopulmonary bypass ( CPB ) on postoperative coagulation and clinical recovery in pediatric patients , aim ing to supply new evidence for evidence -based use of FFP . Method : Eighty pediatric patients with congenital heart disease undergoing cardiac surgery with CPB were r and omized to receive either 10 - 20 ml/kg 4 % succinylated gelatin ( Gelofusine , GEL group , n = 40 ) or 1 - 2 units FFP ( FFP group , n = 40 ) in the pump prime .  Rapid-thromboelastography ( r-TEG ) and functional fibrinogen level  were measured before skin incision and 15 minutes after heparin reversal . We recorded the volume of chest tube drainage , transfusion requirements and the dosage of pharmacological agents . The ventilation time , ICU length of stay and hospitalization time after surgery were also collected . Results : After heparin neutralization , there were significantly elevated levels of fibrinogen in the FFP group , which were manifested by r-TEG parameters MAf and FLEV . No significant differences were observed between the two groups in postoperative bleeding , transfusion requirements and the usage of pharmacological agents . Recovery time was also comparable between the two groups . Conclusion : In conclusion , prophylactic use of FFP in the priming solution does not provide clinical benefits as presumed . Artificial colloids , such as Gelofusine , can be used safely and effectively as a substitute for FFP in the pump prime . TEG is an effective assessment tool to evaluate postoperative coagulation function in pediatric patients OBJECTIVES To assess the benefits of withdrawn autologous plasma , the objective of this study was to investigate whether withdrawal of acutely performed platelet-rich or platelet-poor plasmapheresis allays changes in the protein C-thrombomodulin and fibrinolytic systems after retransfusion secondary to cardiopulmonary bypass ( CPB ) . In addition , the study attempted to determine the influence of acute plasmapheresis ( APP ) on the protein C-thrombomodulin and fibrinolytic systems as well as on homologous blood consumption and perioperative blood loss in elective aortocoronary bypass patients . DESIGN The investigation was scheduled as a prospect i ve , r and omized , unblinded study . SETTING This single investigation was conducted in the Department of Anesthesiology and Intensive Care Medicine at a university in Germany . The study protocol was approved by the Ethics Committee of the hospital , and informed consent was obtained . PARTICIPANTS Sixty male patients scheduled for elective coronary artery bypass grafting with extracorporeal circulation were included in the study . INTERVENTIONS APP was performed between induction of anesthesia and incision , collecting either 10 mL/kg of autologous platelet-poor plasma ( PPP patients , group 1 ; n = 20 ) or the same amount of platelet-rich plasma ( PRP patients , group 2 ; n = 20 ) . Patients of group 3 ( n = 20 ) had no APP ( control group ) . All patients were maintained on their usual regimen of cardiac drugs until the morning of surgery . To preserve hemodynamic stability and restore the intravascular oncotic pressure , the separated plasma was replaced by infusion of an equal amount of hydroxyethyl starch solution ( HES ) ( 6 % HES , molecular weight 2 x 10(5 ) , substitution rate 0.5 % ) . In all operations , the same surgical procedure was chosen . For all patients , induction and maintenance of anesthesia were similar , consisting of weight-related doses of fentanyl ( 35 micrograms/kg ) , midazolam ( 0.65 mg/kg ) , and pancuronium bromide ( 0.15 mg/kg ) . The lungs of all patients were mechanically ventilated during the first 5 hours after the end of the operation . MEASUREMENTS AND MAIN RESULTS All patients had serial coagulation studies including antithrombin ( AT ) III-activity , prekallikrein , factor XII , and immunologic tests such as thrombin-antithrombin III ( TAT ) , fibrinopeptide A ( FPA ) , protein C and S ( PC and PS ) , thrombomodulin ( TM ) , tissue-plasminogen-activator ( t-PA ) , plasminogen-activator-inhibitor ( PAI 1 ) , fibrinopeptide B beta 15 - 42 ( FPB beta 15 - 42 ) , D-dimers , and hemoglobin and platelet counts determined intraoperatively and postoperatively . Chest tube drainage and transfusion requirements were recorded . APP had no negative effects on the quality of PPP and PRP plasma . The platelet count of the withdrawn plasma was 28 + /- 12 x 10(9)/L ( PPP group ) and 245 + /- 36 x 10(9)/L ( PRP group ) . At the end of the operation ( after retransfusion of autologous plasma ) and on the morning of the first postoperative day , platelet counts were significantly higher ( p > 0.05 ) in the PRP than in the PPP and control groups . Plasma concentrations of TAT and FPA increased ( ranging from + 185 % to + 340 % from baseline values ) and AT III-activity , PC , PS , and TM antigen decreased ( ranging from -8 % to -55 % from baseline values ) to a different extent for all three groups throughout CPB . t-PA-activity increased with a maximum at the end of CPB ( PPP group , 6.9 + /- 1.5 IU/mL : PRP group , 3.8 + /- 0.8 IU/mL ; control group , 10.9 + /- 2.8 IU/mL ) . Fibrin and fibrinogen degradation markers such as D-dimers and FPB beta 15 to 42 occurred in peak concentrations after neutralization of heparin by protamine . Only PRP patients showed baseline concentrations of coagulation parameters the next morning ( p < 0.05 ) . Total postoperative blood loss within the first 24 hours reached 482 + /- 273 mL ( PRP group ) , 775 + /- 256 mL ( PPP group ) , and 948 + /- 342 mL in the control group ( p < 0.05 ) . ( ABSTRACT TRUNCATED BACKGROUND Fresh frozen plasma ( FFP ) and prothrombin complex concentrates ( PCC ) reverse oral anticoagulants . We compared PCC and FFP intraoperative administration in patients undergoing heart surgery with cardiopulmonary bypass ( CPB ) . METHODS Forty patients [ with international normalized ratio (INR)≥ 2·1 ] assigned semi-urgent cardiac surgery were r and omized to receive either FFP ( n = 20 ) or PCC ( n = 20 ) . Prior to CPB , they received either 2 units of FFP or half of the PCC dose calculated according to body weight , initial INR and target INR ( ≤ 1·5 ) . After CPB and protamine administration , patients received either another 2 units of FFP or the other half PCC dose . Additional doses were administered if INR was still too high ( ≥ 1·5 ) . RESULTS Fifteen minutes after CPB , more patients reached INR target with PCC ( P = 0·007 ) : 7/16 patients vs. 0/15 patients with FFP ; there was no difference 1 h after CPB ( 6/15 patients with PCC vs. 4/15 patients with FFP reached target ) . Fifteen minutes after CPB , median INR ( range ) decreased to 1·6 ( 1·2 - 2·2 ) with PCC vs. 2·3 ( 1·5 - 3·5 ) with FFP ; 1 h after CPB both groups reached similar values [ 1·6 ( 1·3 - 2·2 ) with PCC and 1·7 ( 1·3 - 2·7 ) with FFP ] . With PCC , less patients needed additional dose ( 6/20 ) than with FFP ( 20/20 ) ( P < 0·001 ) . Both groups differed significantly on the course of factor II ( P = 0·0023 ) and factor X ( P = 0·008 ) over time . Dilution of coagulation factors was maximal at CPB onset . Safety was good for both groups , with only two related oozing cases with FFP . CONCLUSION PCC reverses anticoagulation safely , faster and with less bleeding than FFP Objective To test the tolerability and safety of the universal plasma Uniplas [ solvent/detergent (SD)-treated plasma ] , infused regardless of the patient 's blood group . Design Prospect i ve , parallel group , controlled and observer-blinded study , r and omized with respect to patients requiring plasma transfusion .  Setting Cardiothoracic operating room and ICU in a university hospital . Patients Eighty-four patients undergoing open-heart surgery comparing three parallel treatment groups and one control group . Interventions The Uniplas treatment group was subdivided into patients with blood group A , B or AB , and group O. The treatment group receiving Octaplas of type AB , was not subdivided . Patients who did not require any plasma transfusion  served as control . Measurements Complement activation ( C3bc , TCC ) , direct antiglobulin test ( DAT ) and other immunohaematological tests , tests for haemolysis , and relevant clinical observations during treatment phase . Blood sample s were collected again after 6 months for evaluation of viral safety . Results Of the 84 patients , 29 served as control group . Uniplas was transfused in 36 of the patients ( 1–23 units ) . Octaplas was transfused in 19 patients ( 1–11 units ) . During the study no clinical adverse events related to plasma transfusion were observed . The degree of complement activation C3bc and TCC , a recommended test for biocompatibility , did not show any increased activation after Uniplas or Octaplas transfusion . No haemolytic reactions , positive DAT-tests or viral transmissions were observed after Uniplas transfusion . Conclusion In open-heart surgery , Uniplas , which can be transfused regardless of a patient 's blood group , was well-tolerated and gave no adverse drug reactions BACKGROUND In 2010 ,  transfusion-associated circulatory overload ( TACO ) was the second most common cause of transfusion-related mortality reported to the Food and Drug Administration . We sought to determine the rate of TACO caused by  plasma transfusion . STUDY DESIGN AND METHODS This study was conducted in two parts : 1 ) A retrospective analysis to determine the prevalence of  TACO reactions caused by plasma at a tertiary care hospital from 2003 to 2010 was performed by analyzing the blood bank 's electronic transfusion reaction records and 2 ) active surveillance of  plasma recipients to determine if unreported TACO reactions had occurred over a 1-month period at the same hospital . RESULTS Eighty-seven reactions to plasma had been reported to the blood bank from 2003 through 2010 . Of these reactions 23 % ( 20/87 ) were TACO . The historical prevalence rate of TACO was 1 in 1566 ( 95 % confidence interval [ CI ] , 1:2564 - 1:1014 ) . During the prospect i ve 1-month surveillance period , 84 patients received a total of 272 units of plasma , and four TACO reactions in separate patients ( 4.8 % ) were identified , none of which were reported to the blood bank . The prevalence rate of TACO in the prospect i ve study was 1 in 68 ( 95 % CI , 1:250 - 1:27 ) . In total , most patients ( 14/24 ) were in the intensive care unit when they experienced TACO and on average they had received 4.0±2.3 units of plasma at an average rate of 647±315 mL/hr before the TACO reaction . CONCLUSIONS Passive reporting of TACO grossly underestimates its actual prevalence . Educational efforts are needed to enhance physician recognition of TACO reactions Patients on warfarin for mechanical heart valves are at increased risk for thromboembolic events and intracranial hemmorhage . In current guidelines , a low dose of vitamin K is the recommended treatment for moderate over-anticoagulation based on studies in which only minority patients participating had mechanical heart valves . We performed a r and omized controlled trial to compare the efficacy and safety profile of low-dose intravenous vitamin K and fresh frozen plasma ( FFP ) for patients with mechanical heart valves and mild to moderate over-anticoagulation ( international normalized ratio [ INR ] 4 to 7 ) . In a 24-month period , we r and omized 102 patients to ( 1 ) vitamin K or ( 2 ) FFP . The baseline INR  at presentation between the  vitamin K group and the FFP group was 4.61 + /- 0.007 vs 4.78 + /- 0.07 ( p = 0.11 ) . Six hours after treatment , patients in the FFP group had a significantly lower mean INR compared with the vitamin K group ( 2.75 + /- 0.06 vs 3.44 + /- 0.10 , p = 0.01 ) . No patient in both groups had over-cor 
    Output:
    
This review has found no evidence to support the prophylactic administration of FFP to patients without coagulopathy undergoing elective cardiac surgery .
There was insufficient evidence about treatment of patients with coagulopathies or those who are undergoing emergency surgery .
There were no reported adverse events attributable to FFP transfusion , although there was a significant increase in the number of patients requiring red cell transfusion who were r and omised to FFP .