Outcome of Fresh Frozen Plasma versus albumin in priming solution of extracorporeal circuit in neonatal cardiac surgery: A Prospective Comparative Observational study

Articles in Press

Document Type : Original Article

Authors

U.N.Mehta Institute of Cardiology and Research Center

10.22038/jctm.2026.92371.1517

Abstract

Background and Aims:

In neonatal cardiac surgery, the choice of cardiopulmonary bypass (CPB) priming fluid is important. Fresh frozen plasma (FFP) provides coagulation factors that may reduce bleeding, while albumin maintains oncotic pressure and may protect renal function. This study compared outcomes of FFP- versus albumin-based priming.

Methods:

This prospective observational study (June 2022–October 2024) included 100 neonates (≤5 kg) undergoing CPB. Patients were alternately assigned to receive 10 mL/kg FFP (n = 50) or 5% albumin (n = 50) in the prime. Outcomes included bleeding, transfusion requirements, hemodynamic stability, renal function, mechanical ventilation duration, ICU stay, hospital stay, and mortality. Data were analyzed using t tests and chi-square tests.

Results:

Baseline characteristics were similar. Chest drain output and total blood product use were comparable (p > 0.05), except the FFP group required more albumin transfusion at 24 hours (p = 0.031). Hemodynamics were mostly similar, although mean arterial pressure was slightly higher in the albumin group at 48 hours (p = 0.040). Serum creatinine was significantly higher in the FFP group preoperatively and at 24–48 hours postoperatively (p ≈ 0.02–0.03), while urine output was similar. Duration of ventilation, ICU stay, hospital stay, and mortality showed no difference.

Conclusion:

Albumin priming may offer modest renal protection and reduce donor exposure. FFP remains an acceptable alternative. Larger randomized trials are required.

Keywords

Journal of Cardio-Thoracic Medicine

Articles in Press, Accepted Manuscript
Available Online from 06 January 2026

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