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Published on: February 14, 2017
Theoretical Modeling of Coagulation Management With Therapeutic Plasma or Prothrombin Complex Concentrate
Herbert Schöchl1, Oliver Grottke, Ken Sutor
1From the *Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, AUVA Research Centre, Vienna, Austria; †Department of Anaesthesiology and Intensive Care, AUVA Trauma Centre, Salzburg, Austria; ‡Department of Anesthesiology, RWTH Aachen University Hospital, Aachen, Germany; §Meridian HealthComms Ltd, Plumley, Cheshire, United Kingdom; ‖Parker Design Consultants Ltd, Lostock Gralam, Cheshire, United Kingdom; ¶Trauma, Critical Care and Acute Care Surgery Division, Oregon Health and Science University, Portland, Oregon; #Department of Cardiothoracic and Vascular Anaesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy; and **School of Medicine, Cardiff University and University Hospital of Wales, Cardiff, United Kingdom.
Abstract:
Prothrombin complex concentrates (PCCs) have been associated with a possible risk of thromboembolic complications, potentially attributable to an increased ratio of the plasma concentration of factor II (FII) to antithrombin (AT). We developed a mathematical model to examine the relationship between amounts of PCC or therapeutic plasma administered, and plasma levels of FII and AT. The model showed that PCC produces substantial increases in plasma levels of FII but only small changes in AT, increasing the FII:AT ratio. Therapeutic plasma was shown to have only modest effects on levels of FII or AT, unless high doses are used.
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