Systematic ReviewResearchMedication Safety

PCC reduced early transfusion and chest-tube drainage versus plasma after cardiac surgery, with no detected safety difference

Journal of cardiothoracic surgery (PubMed)Jul 17, 2026

AI-summarized from the linked source. Educational brief, not medical advice.

Brief summary

A meta-analysis of 10 randomized and cohort studies involving 2,643 adults undergoing cardiac surgery found that prothrombin complex concentrate was associated with fewer early red-cell transfusions, less 12- to 24-hour chest-tube drainage, and a shorter hospital stay than fresh frozen plasma, without significant differences in mortality or thromboembolic events.

What NurseJet pulled from the source

This systematic review compared prothrombin complex concentrate (PCC) with fresh frozen plasma for coagulopathic bleeding in adults undergoing cardiac surgery. Across 10 randomized and cohort studies with 2,643 patients, PCC was associated with lower red-cell transfusion requirements during the first 24 hours, about 189 mL less chest-tube drainage from 12 to 24 hours, and a hospital stay shorter by about 1.2 days. The analysis did not detect significant differences in re-exploration, mortality, thromboembolic events, stroke, acute kidney injury, ICU stay, or serious adverse events. Several outcomes had moderate to high heterogeneity, so the absence of a detected safety difference should not be interpreted as proof of equivalent safety.

Why this matters for nurses

Cardiac and critical-care nurses trend chest-tube output, hemodynamics, transfusion exposure, and possible thrombotic or transfusion-related complications after surgery. The review informs surveillance around two provider-directed coagulation strategies.

Bedside takeaway

PCC was linked to less early transfusion and drainage than plasma after cardiac surgery, while mixed-study evidence leaves safety uncertainty.

How This Applies in Practice

Use this when: Monitoring an adult receiving provider-ordered PCC or fresh frozen plasma for bleeding after cardiac surgery.

On your shift

Verify the ordered product and administration plan, then trend chest-tube output, hemodynamics, laboratory results, and additional transfusion needs.
Escalate unexpected bleeding, transfusion reactions, neurologic changes, or other possible thrombotic complications through the cardiac-surgery team.

Keep in mind: Do not choose or substitute a coagulation product from this meta-analysis alone. Follow the cardiac-surgery protocol, facility policy, and patient-specific provider orders.

Explain this for my unit

Key takeaways

The review included 10 randomized and cohort studies with 2,643 adult cardiac-surgery patients.
PCC was associated with lower early red-cell transfusion use and less 12- to 24-hour chest-tube drainage than plasma.
Mortality, thromboembolic events, stroke, acute kidney injury, and serious adverse events did not differ significantly.
Mixed study designs and moderate to high heterogeneity limit certainty for several outcomes.

Practice implications

When PCC or plasma is ordered for post-cardiac-surgery bleeding, verify the product and administration plan and trend bleeding, chest-tube output, transfusion requirements, hemodynamics, and possible complications. Report unexpected bleeding or thrombotic concerns promptly; do not substitute one product for another from this review alone.

Limitations & cautions

The analysis combined randomized trials and cohort studies, and several outcomes had moderate to high heterogeneity. Event estimates may be affected by differences in dosing, bleeding definitions, transfusion protocols, and patient risk. Nonsignificant safety outcomes do not establish equivalence, and the authors call for larger high-quality trials.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations

Exact source links

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Journal of cardiothoracic surgery (PubMed)

Journal of cardiothoracic surgery (PubMed). Efficacy and safety of prothrombin complex concentrate versus fresh frozen plasma in adult patients undergoing cardiac surgery: a systematic review and meta-analysis.

Open original source

https://pubmed.ncbi.nlm.nih.gov/42469870/

Professional education only

This summary does not replace clinical judgment, facility policy, provider orders, or official guidelines. Verify practice changes against the original source and local protocol.

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Nursing open (PubMed)Jul 1, 2026Research ArticlePractice applicable

A randomized trial of 170 adults scheduled for intestinal stoma surgery found that adding practice with a wearable stoma-care training belt to standard preoperative education improved self-care skills, adjustment, anxiety, and education satisfaction through 30 days after discharge.

Med-SurgAI summaryReview source

Research ArticleResearchPatient EducationWorkflowPractice applicableAI summary · original source linked below

Patients at two university hospitals were randomized to standard care alone or standard care plus preoperative belt-based practice. The intervention group had higher stoma-care skill and adjustment scores at every postoperative assessment, lower anxiety from discharge through day 30, and higher satisfaction at the preoperative and discharge assessments. The study evaluated short-term patient-reported and skill outcomes rather than complications or readmissions.

Key takeaways

The trial randomized 170 patients preparing for intestinal stoma surgery at two university hospitals.
The training belt allowed preoperative practice without applying an adhesive system directly to the abdomen.
Skill and adjustment scores favored belt-based practice at discharge and through 30 days after discharge.
The abstract does not establish effects on stoma complications, healthcare use, or outcomes beyond the first postoperative month.

Why this matters on shift

Wound and ostomy nurses help patients build confidence with equipment before they must manage a new stoma at home. The trial supports hands-on rehearsal as an addition to the established teaching pathway while keeping the evidence focused on early skills, adjustment, anxiety, and satisfaction.

Bedside takeaway

Hands-on preoperative stoma practice improved early skills and adjustment, but clinical and longer-term outcomes were not measured.

Nursing implications

When an approved simulation device is available, integrate supervised practice into the existing preoperative stoma-education plan. Observe the patient's technique, revisit difficult steps before discharge, and arrange follow-up for ongoing skill or adjustment concerns.

Limitations & cautions

The trial was conducted in general-surgery departments at two university hospitals and followed patients for 30 days after discharge. The abstract does not report blinding, clinical complications, readmissions, long-term self-management, or whether the findings generalize to other devices, stoma types, or care settings.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Nursing open (PubMed). Effect of a Stoma Care Training Belt on Stoma Care Skills, Adjustment, Anxiety and Satisfaction in Intestinal Stoma Patients: Randomized Controlled Study.

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AI-summarized from the linked source. Review the original article before applying to practice.

Critical care nursing clinics of North America (PubMed)Jun 22, 2026Systematic ReviewPractice applicable

A clinical review describes ICU nurses as central to coordinated prevention of multidrug-resistant organism transmission through stewardship, pathogen surveillance, appropriate isolation precautions, and evidence-based hygiene practices.

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Systematic ReviewInfection ControlWorkflowPatient EducationPractice applicableAI summary · original source linked below

The review links ICU vulnerability to immunosuppression, invasive devices, broad-spectrum antimicrobial exposure, and the care environment. It emphasizes a multimodal, team-based approach rather than a single intervention, including laboratory and antibiotic stewardship, passive and active surveillance, timely use and de-escalation of precautions, and hygiene measures. The abstract does not report a systematic search or pooled patient outcomes.

Key takeaways

Critically ill patients face overlapping exposure risks related to devices, antimicrobials, immune dysfunction, and the ICU environment.
The review frames MDRO prevention as coordinated work across bedside nursing, infection prevention, laboratory, and antimicrobial-stewardship teams.
Nursing responsibilities include surveillance, hygiene, and correct implementation and de-escalation of ordered precautions.
This is a clinical review, so it does not quantify the independent effect of any single prevention measure.

Why this matters on shift

ICU nurses are continuously positioned to recognize new transmission risks, maintain device and hygiene practices, and identify when precaution or antimicrobial plans need clarification. The review supports reliable team coordination while leaving organism-specific actions to current infection-prevention guidance.

Bedside takeaway

MDRO prevention in the ICU depends on coordinated surveillance, precautions, stewardship, hygiene, and reliable bedside execution.

Nursing implications

Verify the organism-specific precaution plan at handoff, perform the approved hygiene and device-care bundle, and communicate changes in cultures, antimicrobial therapy, or isolation status. Escalate uncertainty promptly to infection prevention and the treating team.

Limitations & cautions

The PubMed abstract describes a narrative clinical review without a reported systematic search, evidence grading, sample, or pooled effect estimates. It does not establish the comparative effectiveness of specific surveillance, isolation, stewardship, or hygiene interventions, and local resistance patterns may change implementation.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Critical care nursing clinics of North America (PubMed). Infection Prevention and Control in the Intensive Care Unit: Preventing the Spread of Multi-Drug-Resistant Organisms.

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AI-summarized from the linked source. Review the original article before applying to practice.

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An umbrella review of 13 systematic reviews involving 15,363 people with COPD found that digital self-management interventions improved several pooled health-related outcomes, while evidence certainty ranged from very low to moderate and heterogeneity was substantial.

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Systematic ReviewResearchPatient EducationWorkflowPractice applicableAI summary · original source linked below

Across 11 meta-analyses and two narrative syntheses, digital interventions were associated with improvements in physical activity, quality of life, lung function, adherence, anxiety, and depression. Results were inconclusive for dyspnea, physical capacity, sedentary time, emergency visits, and mortality. Differences among programs, populations, outcomes, and review methods limit confidence in applying one pooled estimate to a specific tool.

Key takeaways

The umbrella review included 13 systematic reviews representing 15,363 participants with COPD.
Pooled findings favored digital self-management for physical activity, quality of life, lung function, adherence, anxiety, and depression.
Effects on dyspnea, physical capacity, sedentary time, emergency visits, and mortality were inconclusive.
Substantial heterogeneity and very low-to-moderate evidence certainty limit claims about a best platform or long-term clinical benefit.

Why this matters on shift

Medical-surgical nurses reinforce COPD self-management before discharge and help identify whether patients can use a digital plan safely after leaving the hospital. The review suggests digital support can extend education and follow-up, but it does not replace individualized assessment or establish fewer emergency visits or deaths.

Bedside takeaway

Digital COPD support may improve several self-management outcomes, but platform choice and escalation still require individualized clinical oversight.

Nursing implications

Confirm that the digital program is part of the clinical care plan and that the patient can access and understand it. Reinforce how to record symptoms, use the program's escalation pathway, and seek direct assessment when symptoms worsen rather than relying on the platform alone.

Limitations & cautions

This umbrella review synthesized existing reviews rather than individual trials. Interventions, comparators, populations, outcome definitions, and follow-up periods varied; heterogeneity was substantial for most outcomes; and GRADE certainty ranged from very low to moderate. The evidence was inconclusive for emergency visits and mortality.
AI-summarized from the linked source. Review the original article before applying to practice.

Citations · exact source links

Pulmonology (PubMed). Effectiveness of self-management digital interventions in improving health-related outcomes in patients with chronic obstructive pulmonary disease: An umbrella review.

Explain this for my unit

Open original sourceFull brief

AI-summarized from the linked source. Review the original article before applying to practice.

How This Applies in Practice

Key takeaways

Practice implications

Limitations & cautions

Exact source links

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Preoperative stoma-belt practice improved self-care skills and adjustment after surgery

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