Using Fresh Frozen Plasma for Acute Airway Angioedema to Prevent Intubation in the Emergency Department: A Retrospective Cohort StudyReport as inadecuate




Using Fresh Frozen Plasma for Acute Airway Angioedema to Prevent Intubation in the Emergency Department: A Retrospective Cohort Study - Download this document for free, or read online. Document in PDF available to download.

Emergency Medicine International - Volume 2016 2016, Article ID 6091510, 6 pages -

Research Article

Department of Internal Medicine, St. John Hospital and Medical Center, 22101 Moross Road, Detroit, MI 48236, USA

Geriatric Research Education and Clinical Center GRECC, VA Ann Arbor Healthcare System, 2215 Fuller Road 11 G, Ann Arbor, MI 48105, USA

Department of Internal Medicine, University of Michigan, 3110 Taubman Center, SPC 5368, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA

Department of Family Medicine, University of Michigan, 1150 W. Medical Center Drive, M7300 Med Sci I, SPC 5625, Ann Arbor, MI 48109, USA

Received 1 December 2015; Revised 11 January 2016; Accepted 20 January 2016

Academic Editor: Wen-Jone Chen

Copyright © 2016 Aya Saeb et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Angioedema AE is a common condition which can be complicated by laryngeal edema, having up to 40% mortality. Although sporadic case reports attest to the benefits of fresh frozen plasma FFP in treating severe acute bouts of AE, little evidence-based support for this practice is available at present. Study Objectives. To compare the frequency, duration of intubation, and length of intensive care unit ICU stay in patients with acute airway AE, with and without the use of FFP. Methods. A retrospective cohort study was conducted, investigating adults admitted to large community hospital ICU with a diagnosis of AE during the years of 2007–2012. Altogether, 128 charts were reviewed for demographics, comorbidities, hospital courses, and outcomes. A total of 20 patients received FFP 108 did not. Results. Demographics and comorbidities did not differ by treatment group. However, nontreated controls did worse in terms of intubation frequency 60% versus 35%; and ICU stay 3.5 days versus 1.5 days; . Group outcomes were otherwise similar. Conclusion. In an emergency department setting, the use of FFP should be considered in managing acute airway nonhereditary AE refractory to steroid, antihistamine, and epinephrine. Larger prospective, better controlled studies are needed to devise appropriate treatment guidelines.





Author: Aya Saeb, Karen H. Hagglund, and Christine T. Cigolle

Source: https://www.hindawi.com/



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