Use of prothrombin complex concentrate for excessive bleeding after cardiac surgery

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Published on: July 31, 2016

Vrigina Arnékian1, Julien Camous, Soly Fattal

  • 1Cardiothoracic Intensive Care Unit, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.

Interactive Cardiovascular and Thoracic Surgery
|May 25, 2012
PubMed

Insights

Low-dose prothrombin complex concentrates (PCCs) effectively reduced bleeding after cardiopulmonary bypass (CPB). This study evaluated PCC

Area of Science:

  • Cardiovascular Surgery
  • Hematology
  • Anesthesiology

Background:

  • Excessive bleeding is a significant complication following cardiopulmonary bypass (CPB).
  • Prothrombin complex concentrates (PCCs) are sometimes used off-label to manage post-CPB bleeding.
  • Clinical and biological efficacy of PCC in this setting requires further evaluation.

Purpose of the Study:

  • To retrospectively assess the clinical and biological efficacy of prothrombin complex concentrates (PCCs).
  • To evaluate PCC's effectiveness in managing excessive bleeding after cardiopulmonary bypass (CPB).
  • To compare PCC with other hemostatic therapies in the post-CPB setting.

Main Methods:

  • Retrospective chart review of patients undergoing cardiac surgery with CPB over two years.
  • Identification of patients treated for active bleeding with hemostatic therapy.
  • Quantification of chest tube blood loss, coagulation parameters, and thromboembolic complications.

Main Results:

  • Seventy-seven patients were included: 24 received PCC alone (Group I), 26 received fresh frozen plasma (Group II), and 27 received both (Group III).
  • Group I showed a significant difference in initial blood loss compared to Group III (P=0.02).
  • Re-exploration for bleeding occurred in 4% of Group I, 8% of Group II, and 37% of Group III (P=0.002).

Conclusions:

  • Low-dose prothrombin complex concentrate administration significantly decreased postoperative bleeding after CPB.
  • PCC demonstrated efficacy in reducing the need for re-exploration due to bleeding.
  • Further research may support the use of PCC for managing post-cardiopulmonary bypass bleeding.
Abstract

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