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Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation

A multicenter, retrospective, observational study of 4-factor prothrombin complex concentrate (PCC) and/or fresh frozen plasma (FFP) use within routine clinical care unrelated to vitamin K antagonists was conducted. The PCC was administered preprocedure for correction of coagulopathy (prophylactic c...

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Detalles Bibliográficos
Autores principales: Chowdary, Pratima, Tang, Augustine, Watson, Dale, Besser, Martin, Collins, Peter, Creagh, Michael Desmond, Qureshi, Hafiz, Rokicka, Margaret, Nokes, Tim, Diprose, Paul, Gill, Ravi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714747/
https://www.ncbi.nlm.nih.gov/pubmed/29415562
http://dx.doi.org/10.1177/1076029617753537
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author Chowdary, Pratima
Tang, Augustine
Watson, Dale
Besser, Martin
Collins, Peter
Creagh, Michael Desmond
Qureshi, Hafiz
Rokicka, Margaret
Nokes, Tim
Diprose, Paul
Gill, Ravi
author_facet Chowdary, Pratima
Tang, Augustine
Watson, Dale
Besser, Martin
Collins, Peter
Creagh, Michael Desmond
Qureshi, Hafiz
Rokicka, Margaret
Nokes, Tim
Diprose, Paul
Gill, Ravi
author_sort Chowdary, Pratima
collection PubMed
description A multicenter, retrospective, observational study of 4-factor prothrombin complex concentrate (PCC) and/or fresh frozen plasma (FFP) use within routine clinical care unrelated to vitamin K antagonists was conducted. The PCC was administered preprocedure for correction of coagulopathy (prophylactic cohort) and treatment of bleeding postsurgery (treatment cohort). Of the 445 patients included, 40 were in the prophylactic cohort (PCC alone [n = 16], PCC and FFP [n = 5], FFP alone [n = 19]) and 405 were in the treatment cohort (PCC alone [n = 228], PCC and FFP [n = 123], FFP alone [n = 54]). Cardiovascular surgery was the most common setting. PCC doses ranged between 500 and 5000 IU. Effectiveness (assessed retrospectively) was reported as effective in 93.0% in the PCC-only group (95% confidence interval, 89.1% to 95.9%), 78.9% (70.8% to 85.6%) with PCC and FFP, and 86.3% (76.2% to 93.2%) with FFP alone. In the treatment cohort, international normalized ratio was significantly reduced in all 3 groups. In patients who received PCC, the rate of thromboembolic events (1.9%) was below rates in the literature for similar procedures. PCCs offer a potential alternative to FFP in the management of perioperative bleeding unrelated to oral anticoagulant therapy.
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spelling pubmed-67147472019-09-04 Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation Chowdary, Pratima Tang, Augustine Watson, Dale Besser, Martin Collins, Peter Creagh, Michael Desmond Qureshi, Hafiz Rokicka, Margaret Nokes, Tim Diprose, Paul Gill, Ravi Clin Appl Thromb Hemost Original Articles A multicenter, retrospective, observational study of 4-factor prothrombin complex concentrate (PCC) and/or fresh frozen plasma (FFP) use within routine clinical care unrelated to vitamin K antagonists was conducted. The PCC was administered preprocedure for correction of coagulopathy (prophylactic cohort) and treatment of bleeding postsurgery (treatment cohort). Of the 445 patients included, 40 were in the prophylactic cohort (PCC alone [n = 16], PCC and FFP [n = 5], FFP alone [n = 19]) and 405 were in the treatment cohort (PCC alone [n = 228], PCC and FFP [n = 123], FFP alone [n = 54]). Cardiovascular surgery was the most common setting. PCC doses ranged between 500 and 5000 IU. Effectiveness (assessed retrospectively) was reported as effective in 93.0% in the PCC-only group (95% confidence interval, 89.1% to 95.9%), 78.9% (70.8% to 85.6%) with PCC and FFP, and 86.3% (76.2% to 93.2%) with FFP alone. In the treatment cohort, international normalized ratio was significantly reduced in all 3 groups. In patients who received PCC, the rate of thromboembolic events (1.9%) was below rates in the literature for similar procedures. PCCs offer a potential alternative to FFP in the management of perioperative bleeding unrelated to oral anticoagulant therapy. SAGE Publications 2018-02-07 2018-10 /pmc/articles/PMC6714747/ /pubmed/29415562 http://dx.doi.org/10.1177/1076029617753537 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Chowdary, Pratima
Tang, Augustine
Watson, Dale
Besser, Martin
Collins, Peter
Creagh, Michael Desmond
Qureshi, Hafiz
Rokicka, Margaret
Nokes, Tim
Diprose, Paul
Gill, Ravi
Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation
title Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation
title_full Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation
title_fullStr Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation
title_full_unstemmed Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation
title_short Retrospective Review of a Prothrombin Complex Concentrate (Beriplex P/N) for the Management of Perioperative Bleeding Unrelated to Oral Anticoagulation
title_sort retrospective review of a prothrombin complex concentrate (beriplex p/n) for the management of perioperative bleeding unrelated to oral anticoagulation
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6714747/
https://www.ncbi.nlm.nih.gov/pubmed/29415562
http://dx.doi.org/10.1177/1076029617753537
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