Abstract | BACKGROUND:
Prothrombin complex concentrates (PCC) are approved for urgent reversal of vitamin K antagonists (VKA). Recently, PCC have been used in the management of massive bleeding-associated coagulopathy. The present work evaluates safety and efficacy of PCC in a case series of both VKA reversal and massive bleeding. METHODS: Retrospective review of cases treated with CCP (January 2010 to February 2013). Safety endpoints were infusion reactions and incidence of thromboembolic events. Efficacy endpoints were: 1) VKA reversal efficacy and 2) Massive bleeding coagulopathy reversal and 24h mortality. RESULTS: Thirty-one patients were included (22 male), median age 61 years (range 30-86). No infusion reactions were detected, and only 1 thrombotic episode was observed. VKA reversal was effective in 100% of patients (6/6), all of them with complete reversal of INR value. In massive bleeding, 24-hour survival was 64% (16/25). Invasive hemostatic procedures were required in 28% of patients (7/25). CCP use was correlated with bleeding control in 44% of cases (11/25), and also significantly associated with survival (p=0.01). CONCLUSION: CCP are safe and effective for the novel indication of adjuvant treatment in massive bleeding patients, as well as for traditional urgent reversal of VKA.
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Authors | N Martínez-Calle, M Marcos-Jubilar, A Alfonso, M Hernández, F Hidalgo, R Lecumberri, Ja Páramo |
Journal | Anales del sistema sanitario de Navarra
(An Sist Sanit Navar)
2014 Sep-Dec
Vol. 37
Issue 3
Pg. 363-9
ISSN: 2340-3527 [Electronic] Spain |
Vernacular Title | Seguridad y eficacia de un concentrado de complejo protrombínico en pacientes con coagulopatía y hemorragia. |
PMID | 25567390
(Publication Type: Journal Article)
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Chemical References |
- Blood Coagulation Factors
- prothrombin complex concentrates
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Blood Coagulation Disorders
(drug therapy)
- Blood Coagulation Factors
(therapeutic use)
- Female
- Hemorrhage
(drug therapy)
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Treatment Outcome
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