Comparison of fresh frozen plasma and prothrombin complex concentrate for the reversal of oral anticoagulants in patients undergoing cardiopulmonary bypass surgery: a randomized study

Abstract

PCC reverses anticoagulation safely, faster and with less bleeding than FFP.

Prothrombin complex concentrates in emergency bleeding disorders

“…Typically, PCCs reverse anticoagulation faster and with less bleeding when compared with FFP [40,41]. In a retrospective study that compared strategies for the management of VKArelated intracerebral hemorrhage, PCC-based treatment was associated with less hematoma growth than was FFP-based treatment, an effect apparently related to the more rapid INR reversal achieved with PCC treatment [42].…”

“…Furthermore, PCC treatment yielded satisfactory hemostasis in 36% of the surgical bleeding patients and 96% of the patients with diffuse bleeding (no evidence of damaged blood vessels). In a randomized study that used rapid point of care monitoring of thrombin generation to evaluate the need for factor replacement, significantly more patients achieved target INR (1.5) with PCC (Cofact) versus FFP therapy within 15 min after the procedure (7/16 vs. 0/15; P 5 0.007) [41]. However, the percentage of patients achieving the target at 15 min was considered low in both groups, and there was no statistical difference between groups 1 hr after the procedure (PCC 5 6/15, FFP 5 4/15) [41].…”

“…In a randomized study that used rapid point of care monitoring of thrombin generation to evaluate the need for factor replacement, significantly more patients achieved target INR (1.5) with PCC (Cofact) versus FFP therapy within 15 min after the procedure (7/16 vs. 0/15; P 5 0.007) [41]. However, the percentage of patients achieving the target at 15 min was considered low in both groups, and there was no statistical difference between groups 1 hr after the procedure (PCC 5 6/15, FFP 5 4/15) [41]. In this study, postsurgery blood loss through chest tube drainage was less with PCC than with FFP therapy at 1, 4, and 24 hr after surgery.…”

Perioperative Management of Antithrombotic and Antiplatelet Therapy

“…The PCCs contain adequate amounts of all 4 vitamin Kdependent factors (II, VII, IX, and X), as well as anticoagulants (proteins C and S). 6,7 Because PCCs contain heparin, their use in patients with heparininduced thrombocy topenia is proscribed.…”

Epidemiological features of warfarin overdose and efficacy of prothrombin complex concentrates

“…Reversal of prothrombin time to normal levels with vitamin K lasts 12-24 hours. Reversal of INR to normal values takes an average of 30 hours with FFP, and is associated with volume overload (Demeyere et al, 2010;Dentali et al, 2011;Patanwala et al, 2011). No studies have evaluated the efficacy of PCC in Turkey.…”