{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T15:07:37Z","timestamp":1793286457097,"version":"4.5.0"},"reference-count":43,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Thoracic aorta dissection is an acute critical condition associated with shock-induced endotheliopathy, coagulopathy, massive bleeding, and significant morbidity and mortality. Our aim was to compare the effect of coagulation support with solvent\/detergent-treated pooled plasma (OctaplasLG) versus standard fresh frozen plasma (FFP) on glycocalyx and endothelial injury, bleeding, and transfusion requirements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Investigator-initiated, single-center, blinded, randomized clinical pilot trial of adult patients undergoing emergency surgery for thoracic aorta dissection. Patients were randomized to receive OctaplasLG or standard FFP as coagulation factor replacement related to bleeding. The primary outcome was glycocalyx and endothelial injury. Other outcomes included bleeding, transfusions and prohemostatics at 24 hours, organ failure, length of stay in the intensive care unit and in the hospital, safety, and mortality at 30 and 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Fifty-seven patients were included to obtain 44 evaluable on the primary outcome. The OctaplasLG group displayed significantly reduced damage to the endothelial glycocalyx (syndecan-1) and reduced endothelial tight junction injury (sVE-cadherin) compared to standard FFP. In the OctaplasLG group compared to the standard FFP, days on ventilator (1 day [interquartile range, 0\u20131] vs 2 days [1\u20133];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .013), bleeding during surgery (2150 [1600\u20133087] vs 2750 [2130\u20136875];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .046), 24-hour total transfusion and platelet transfusion volume (3975 mL [2640\u20136828 mL] vs 6220 mL [4210\u201310,245 mL];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .040, and 1400 mL [1050\u20132625 mL] vs 2450 mL [1400\u20133500 mL];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .027), and goal-directed use of prohemostatics (7\/23 [30.4%] vs 13\/21 [61.9%];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .036) were all significantly lower. Among the 57 patients randomized, 30-day mortality was 20.7% (6\/29) in the OctaplasLG group and 25% (7\/28) in the standard FFP group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .760). No safety concern was raised.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of prohemostatics, and time on ventilator after surgery compared to standard FFP. An adequately powered multicenter trial is warranted to confirm the clinical importance of the findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1213\/ane.0000000000003545","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T11:23:09Z","timestamp":1527852189000},"page":"920-927","source":"Crossref","is-referenced-by-count":37,"title":["Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections: The VIPER-OCTA Randomized Clinical Pilot Trial"],"prefix":"10.1213","volume":"127","author":[{"given":"Jakob","family":"Stensballe","sequence":"first","affiliation":[{"name":"Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Denmark"},{"name":"Department of Anesthesia, Centre of Head and Orthopedics, Copenhagen University Hospital, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette G.","family":"Ulrich","sequence":"additional","affiliation":[{"name":"Cardiothoracic Anesthesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens C.","family":"Nilsson","sequence":"additional","affiliation":[{"name":"Cardiothoracic Anesthesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne H.","family":"Henriksen","sequence":"additional","affiliation":[{"name":"Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter S.","family":"Olsen","sequence":"additional","affiliation":[{"name":"Cardiothoracic Surgery, Heart Centre, Copenhagen University Hospital, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisse R.","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e4r I.","family":"Johansson","sequence":"additional","affiliation":[{"name":"Section for Transfusion Medicine, Capital Region Blood Bank, Copenhagen University Hospital, Rigshospitalet, Denmark"},{"name":"Department of Surgery, Division of Acute Care Surgery, Centre for Translational Injury Research (CeTIR), University of Texas Medical School at Houston, Houston, Texas"},{"name":"Center for Systems Biology, the School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230721","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1001\/jamasurg.2014.1327","article-title":"Aortic morphologic findings after thoracic endovascular aortic repair for type B aortic dissection.","volume":"149","author":"Sigman","year":"2014","journal-title":"JAMA 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