Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation

被引:17
作者
Chowdary, Pratima [1 ,2 ]
Tang, Augustine [3 ,4 ]
Watson, Dale [3 ]
Besser, Martin [5 ]
Collins, Peter [6 ]
Creagh, Michael Desmond [7 ]
Qureshi, Hafiz [8 ]
Rokicka, Margaret [9 ]
Nokes, Tim [10 ]
Diprose, Paul [11 ]
Gill, Ravi [11 ]
机构
[1] Royal Free Hosp, Katharine Dormandy Haemophilia Ctr, London, England
[2] Royal Free Hosp, Thrombosis Unit, Pond St, London NW3 2QG, England
[3] Blackpool Teaching Hosp FT, Lancashire Cardiac Ctr, Blackpool, England
[4] Univ Lancaster, Fac Hlth & Med, Lancaster, England
[5] Univ Cambridge, Addenbrookes Hosp, Cambridge, England
[6] Univ Hosp Wales, Arthur Bloom Haemophilia Ctr, Cardiff, S Glam, Wales
[7] Royal Cornwall Hosp, Dept Haematol, Truro, England
[8] Glenfield Hosp, Dept Transfus Med, Leicester, Leics, England
[9] Royal Blackburn Hosp, Blackburn, Lancs, England
[10] Derriford Hosp, Plymouth, Devon, England
[11] Univ Hosp Southampton, Dept Anaesthesia, Southampton, Hants, England
关键词
bleeding; cardiovascular surgery; fresh frozen plasma; prophylaxis; prothrombin complex concentrate; FRESH-FROZEN PLASMA; CRITICALLY-ILL PATIENTS; THROMBIN GENERATION; CARDIAC-SURGERY; CARDIOPULMONARY BYPASS; EFFICACY; COAGULOPATHY; COAGULATION; TRANSFUSION; GUIDELINES;
D O I
10.1177/1076029617753537
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
A multicenter, retrospective, observational study of 4-factor prothrombin complex concentrate (PCC) and/or fresh frozen plasma (FFP) use within routine clinical care unrelated to vitamin K antagonists was conducted. The PCC was administered preprocedure for correction of coagulopathy (prophylactic cohort) and treatment of bleeding postsurgery (treatment cohort). Of the 445 patients included, 40 were in the prophylactic cohort (PCC alone [n = 16], PCC and FFP [n = 5], FFP alone [n = 19]) and 405 were in the treatment cohort (PCC alone [n = 228], PCC and FFP [n = 123], FFP alone [n = 54]). Cardiovascular surgery was the most common setting. PCC doses ranged between 500 and 5000 IU. Effectiveness (assessed retrospectively) was reported as effective in 93.0% in the PCC-only group (95% confidence interval, 89.1% to 95.9%), 78.9% (70.8% to 85.6%) with PCC and FFP, and 86.3% (76.2% to 93.2%) with FFP alone. In the treatment cohort, international normalized ratio was significantly reduced in all 3 groups. In patients who received PCC, the rate of thromboembolic events (1.9%) was below rates in the literature for similar procedures. PCCs offer a potential alternative to FFP in the management of perioperative bleeding unrelated to oral anticoagulant therapy.
引用
收藏
页码:1159 / 1169
页数:11
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