Related Experiment Video
Updated: Apr 14, 2026
06:23
Assessment of Plasma Coagulation on Liver Tissue in a Large Animal Model In Vivo
Published on: August 4, 2018
9.3K
Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery: The FARES-II
Keyvan Karkouti1,2,3, Jeannie L Callum4,5, Justyna Bartoszko1,2,3
1Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
JAMA
|March 29, 2025
Summary
Four-factor prothrombin complex concentrate (PCC) demonstrated superior hemostatic efficacy and safety compared to frozen plasma for treating bleeding in cardiac surgery patients. This finding suggests PCC is a more effective alternative for managing coagulopathic bleeding post-cardiac surgery.
Area of Science:
- Cardiovascular Surgery
- Hematology
- Critical Care Medicine
Background:
- Excessive bleeding is a significant complication following cardiac surgery.
- Coagulation factor deficiency often necessitates treatment with frozen plasma.
- Four-factor prothrombin complex concentrate (PCC) presents a potential alternative therapy.
Purpose of the Study:
- To compare the efficacy and safety of PCC versus frozen plasma.
- To evaluate treatment outcomes in adult patients with coagulopathic bleeding after cardiac surgery.
Main Methods:
- An unblinded, randomized, noninferiority controlled trial.
- Involved 538 adult patients across 12 North American hospitals.
- Patients received either PCC or frozen plasma for bleeding post-cardiac surgery.
Main Results:
- PCC showed superior hemostatic effectiveness (77.9% vs 60.4%) compared to frozen plasma.
- Patients receiving PCC required fewer blood product transfusions (mean 6.6 vs 9.3 units).
- PCC was associated with fewer serious adverse events and less acute kidney injury.
Conclusions:
- Four-factor PCC is a more effective and safer alternative to frozen plasma for coagulopathic bleeding in cardiac surgery.
- PCC offers significant hemostatic benefits and reduces transfusion requirements.
- The findings support the use of PCC in managing post-cardiac surgery bleeding.
Related Concept Videos
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
2.5K
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
2.5K
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
2.8K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
2.8K
01:05Introduction to Hemostasis
18.3K
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
18.3K
01:09Coagulation
12.3K
The coagulation phase is a critical part of the body's process to prevent blood loss following injury to blood vessels. It involves chemical reactions that form a clot to seal the injured area. The clotting process begins shortly after injury, within 15-20 seconds for severe damage and 1-2 minutes for minor injuries.
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
12.3K
01:29Venous Thrombosis III: Interprofessional Care
471
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
471
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
682
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
682