Safety and efficacy of prothrombin complex concentrates for the treatment of coagulopathy after cardiac surgery

The Journal of Thoracic and Cardiovascular Surgery
Howard K SongMick M Scanlan

Abstract

Coagulopathy is an important cause of bleeding after complex cardiac surgery. The conventional treatment for coagulopathy is transfusion, which is associated with adverse outcomes. We report our initial experience with the prothrombin complex concentrate FEIBA (factor VIII inhibitor bypassing activity) for the rescue treatment of coagulopathy and life-threatening bleeding after cardiac surgery. Twenty-five patients who underwent cardiac surgery with coagulopathy and life-threatening bleeding refractory to conventional treatment received FEIBA as rescue therapy at our institution. This cohort represents approximately 2% of patients undergoing cardiac surgery in our university-based practice during the study. The patients were at high risk for postoperative coagulopathy with nearly all patients having at least 2 risk factors for this. Aortic root replacement (Bentall or valve-sparing procedure) and heart transplant with or without left ventricular assist device explant were the most common procedures. The mean FEIBA dose was 2154 units. The need for fresh frozen plasma and platelet transfusion decreased significantly after FEIBA administration (P = .0001 and P < .0001). The mean internationalized normalized ratio decreased from 1...Continue Reading

References

Jul 25, 1974·The New England Journal of Medicine·E M Kurczynski, J A Penner
Dec 22, 1999·Haemophilia : the Official Journal of the World Federation of Hemophilia·D Green
Jul 28, 2004·Intensive Care Medicine·Domenico PaparellaMichael R Buchanan
Mar 31, 2005·The Annals of Thoracic Surgery·Michael E HalkosHoward K Song
Jan 19, 2006·JAMA : the Journal of the American Medical Association·Kathryn A O'ConnellM Miles Braun
Apr 25, 2006·Anesthesia and Analgesia·Stefano RomagnoliCarlo Sorbara
Jan 30, 2007·The Annals of Thoracic Surgery·Oliver WarrenThanos Athanasiou
Aug 31, 2007·American Journal of Hematology·Cindy A LeissingerBruce Ewenstein
Jan 29, 2008·The Annals of Thoracic Surgery·Marco RanucciGiuseppe Isgrò
Mar 20, 2009·Current Opinion in Anaesthesiology·Jean-François HardyPhilippe Van der Linden
Aug 25, 2009·The Journal of Thoracic and Cardiovascular Surgery·Michael C ChristensenChristian von Heymann
May 31, 2011·The Annals of Thoracic Surgery·Alessandro VivacquaJoseph F Sabik
Jul 27, 2011·The Annals of Thoracic Surgery·Andrej AlfirevicColleen G Koch
Mar 31, 2012·Seminars in Thrombosis and Hemostasis·Caroline Cromwell, Louis M Aledort
Apr 17, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mate PetricevicIvan Burcar
Dec 12, 2012·Current Opinion in Anaesthesiology·Christian F WeberKai Zacharowski

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Citations

Jan 8, 2016·Critical Care : the Official Journal of the Critical Care Forum·Giangiuseppe CappabiancaCesare Beghi
Dec 3, 2014·The Journal of Thoracic and Cardiovascular Surgery·Jerrold H Levy
May 30, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Edmund H JoosteIan J Welsby
Apr 9, 2017·Seminars in Cardiothoracic and Vascular Anesthesia·Patrick OdonkorKenichi A Tanaka
Apr 11, 2017·Paediatric Anaesthesia·Nina A Guzzetta, Glyn D Williams
Jan 16, 2018·The Annals of Pharmacotherapy·Sarah L MehringerV Seenu Reddy
Sep 14, 2018·Anesthesia and Analgesia·Stephen H GregoryMadhav Swaminathan
Oct 18, 2014·World Journal of Clinical Cases·Laurence WeinbergPeter McCall
Mar 17, 2016·Anesthesia and Analgesia·Kamrouz GhadimiIan J Welsby
Jan 29, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Yaron D BaracIan Welsby
Feb 26, 2020·World Journal for Pediatric & Congenital Heart Surgery·Lisa Wise-FaberowskiDoff B McElhinney
Aug 26, 2020·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Rachel B CarrollNina A Guzzetta
May 2, 2017·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerKai Zacharowski

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