Experience with prothrombin complex for the emergent reversal of anticoagulation in rural geriatric trauma patients

Quick, Jacob; Bartels, Ashley; Coughenour, Jeffrey P.; Barnes, Stephen L.

doi:10.1016/j.surg.2012.07.024

Cited by 11 publications

(9 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…9 Our results are consistent with findings from this trial and those from previous retrospective cohort studies (including for trauma and spontaneous haemorrhage), which have shown that 4F-PCCs used for VKA reversal can more rapidly replace vitamin K-dependent coagulation factors and lower INR than plasma. 17–20…”

Section: Discussionmentioning

confidence: 99%

Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial

et al. 2015

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial

et al. 2015

View full text Add to dashboard Cite

show abstract

“…The combination of increased need and diminished storage ability of traditional thawed universal plasma donor creates a need for an adjunct plasma product. While PCCs and lyophilized plasma may be viable options, the current standard of care relies on the use of plasma for the reversal of traumatic coagulopathy . Given these factors, an expanded universal donor product is required.…”

Section: Discussionmentioning

confidence: 99%

“…Solutions include the use of viable alternatives to plasma, improving the speed of blood typing to ensure rapid use of matched products, and minimization of unnecessary plasma transfusions. Additionally, utilization of alternatives to plasma, including prothrombin complex concentrates (PCC) and lyophilized plasma, as well as the expansion of the universal plasma product to include male Group A plasma, have been proposed …”

Section: Introductionmentioning

confidence: 99%

Multicenter Comparison of Emergency Release Group A versus AB Plasma in Blunt-Injured Trauma Patients

Zielinski

Schrager

Johnson

et al. 2014

Clinical And Translational Science

View full text Add to dashboard Cite

INTRODUCTION Group AB plasma, the traditional universal donor plasma product, is a limited resource. We compared outcomes of Group A plasma transfusion in comparison to AB. METHODS Analysis of blunt-injured patients who received emergency release plasma from was performed. Multivariable logistic regression was utilized to identify associations with morbidity and mortality. RESULTS There were 191 patients; 115 Group A and 76 Group AB. No differences were seen in age, sex, plasma transfusions, uncrossmatched red blood cells (RBCs), and Glasgow Coma Scale (GCS). Patients who received Group A plasma had significantly lower Injury Severity Score, chest Abbreviated Injury Scale, and scene transfer rate but not head AIS, or abdomen AIS. In addition, significant differences were noted in terms of blood products transfused within 24 hours in those receiving Group A over AB. Development of acute respiratory distress syndrome (ARDS), but not mortality, was higher within the AB cohort. No hemolytic or transfusion associated-ARDS reactions were noted in either group. ARDS; RBC transfusion volumes and head AIS were independently associated with mortality. CONCLUSION Utilization of Group A plasma for emergency blood resuscitation is a safe option which may alleviate potential shortages of AB plasma.

show abstract

“…2,3 Clinical and experimental studies suggest that PCC rapidly reverses warfarin anticoagulation and also reduces the hematoma volume. 2,13,37,38 However, clinical data from randomized trials are still missing. Our results confirm that INR values in anticoagulated mice were normalized within 15 minutes after PCC injection.…”

Section: Discussionmentioning

confidence: 99%

Imaging of Contrast Medium Extravasation in Anticoagulation-Associated Intracerebral Hemorrhage With Dual-Energy Computed Tomography

Won

Schlunk

Dinkel

et al. 2013

Stroke

View full text Add to dashboard Cite

Background and Purpose Contrast medium extravasation (CE) in intracerebral hemorrhage (ICH) is a marker of ongoing bleeding and a predictor of hematoma expansion. The aims of the study were to establish an ICH model in which CE can be quantified, characterized in ICH during warfarin and dabigatran anticoagulation, and to evaluate effects of prothrombin complex concentrates on CE in warfarin-associated ICH. Methods CD 1-mice were pretreated orally with warfarin, dabigatran, or vehicle. Prothrombin complex concentrates were administered in a subgroup of warfarin-treated mice. ICH was induced by stereotactic injection of collagenase VIIs into the right striatum. Contrast agent (350 µL Isovue 370 mg/mL) was injected intravenously after ICH induction (2–3.5 hours). Thirty minutes later, mice were euthanized, and CE was measured by quantifying the iodine content in the hematoma using dual-energy computed tomography. Results The optimal time point for contrast injection was found to be 3 hours after ICH induction, allowing detection of both an increase and a decrease of CE using dual-energy computed tomography. CE was higher in the warfarin group compared with the controls (P=0.002). There was no significant difference in CE between dabigatran-treated mice and controls. CE was higher in the sham-treated warfarin group than in the prothrombin complex concentrates–treated warfarin group (P<0.001). Conclusions Dual-energy computed tomography allows quantifying CE, as a marker of ongoing bleeding, in a model of anticoagulation-associated ICH. Dabigatran induces less CE in ICH than warfarin and consequently reduces risks of hematoma expansion. This constitutes a potential safety advantage of dabigatran over warfarin. Nevertheless, in case of warfarin anticoagulation, prothrombin complex concentrates reduce this side effect.

show abstract

Experience with prothrombin complex for the emergent reversal of anticoagulation in rural geriatric trauma patients

Cited by 11 publications

References 16 publications

Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial

Four-factor prothrombin complex concentrate versus plasma for rapid vitamin K antagonist reversal in patients needing urgent surgical or invasive interventions: a phase 3b, open-label, non-inferiority, randomised trial

Multicenter Comparison of Emergency Release Group A versus AB Plasma in Blunt-Injured Trauma Patients

Imaging of Contrast Medium Extravasation in Anticoagulation-Associated Intracerebral Hemorrhage With Dual-Energy Computed Tomography

Contact Info

Product

Resources

About