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Prothrombin Complex Concentrates to Treat Coagulation Disturbances: An Overview With a Focus on Use in Infants and
Dolly M Munlemvo1, Joseph D Tobias1,2, Kristin M Chenault1,2
1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Cardiology Research
|February 25, 2022
Summary
Prothrombin complex concentrates (PCCs) offer a potential solution for managing coagulation disturbances after congenital heart surgery when standard treatments fail. This review examines PCC use in pediatric patients, focusing on their role in improving outcomes following complex cardiac procedures.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Pediatric Critical Care
Background:
- Coagulation disturbances are common after cardiopulmonary bypass for congenital heart disease.
- These disturbances can lead to severe complications, including hemorrhage and mortality.
- Standard treatments like fresh frozen plasma and cryoprecipitate may not always be effective.
Purpose of the Study:
- To review available prothrombin complex concentrate (PCC) products.
- To examine the use of PCCs in pediatric patients, particularly after congenital heart surgery.
- To outline the potential role of PCCs in managing refractory coagulopathy.
Main Methods:
- Review of existing literature on PCC formulations (3-factor, 4-factor, FEIBA).
- Analysis of case series and anecdotal reports of PCC use in pediatric populations.
- Focus on clinical scenarios following congenital heart surgery.
Main Results:
- PCCs are used when routine blood product therapy is insufficient.
- Limited but growing evidence exists for PCC use in pediatric patients.
- PCCs can rapidly replenish coagulation factors.
Conclusions:
- Prothrombin complex concentrates (PCCs) represent a valuable adjunct for managing severe bleeding after congenital heart surgery.
- Further research is needed to establish optimal dosing and efficacy in pediatric populations.
- PCCs may help mitigate risks associated with coagulopathy in this vulnerable patient group.
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