Therapy with activated prothrombin complex concentrate is effective in reducing dabigatran-associated blood loss in a porcine polytrauma model

Thrombosis and Haemostasis
Markus HonickelOliver Grottke

Abstract

Clinical use of non-vitamin K antagonist oral anticoagulants is increasingly well established. However, specific agents for reversal of these drugs are not currently available. It was to objective of this study to investigate the impact of activated prothrombin complex concentrate (aPCC) on the anticoagulant effects of dabigatran in a randomised, controlled, porcine trauma model. Twenty-one pigs received oral and intravenous dabigatran, resulting in supratherapeutic plasma concentrations. Twelve minutes after injury (standardised bilateral femur fractures and blunt liver injury), animals (n=7/group) received 25 or 50 U/kg aPCC (aPCC25 and aPCC50) or placebo (control) and were followed for 5 hours. The primary endpoint was total volume of blood loss (BL). Haemodynamic and coagulation variables (prothrombin time [PT], activated partial thromboplastin time, diluted thrombin time, thrombin-antithrombin complexes, thromboelastometry, thrombin generation and D-dimers) were measured. Twelve minutes post-injury, BL was similar between groups. Compared with control (total BL: 3807 ± 570 ml) and aPCC25 (3690 ± 454 ml; p=0.77 vs control), a significant reduction in total BL (1639 ± 276 ml; p< 0.0001) and improved survival (p< 0.05) was ob...Continue Reading

References

May 2, 2000·American Journal of Preventive Medicine·R CrosbyR Brackbill
Apr 15, 2003·Toxicology and Applied Pharmacology·Tsung-Ming ShihJohn H McDonough
Jun 17, 2004·Journal of Clinical Pharmacology·Joanne Van RynMichel Pairet
Jun 19, 2004·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Christine Hanker DuselHerbert König
Jan 12, 2007·Injury·Marc MaegeleUNKNOWN AG Polytrauma of the German Trauma Society (DGU)
Nov 3, 2007·Current Opinion in Critical Care·Karim BrohiRoss A Davenport
May 13, 2008·The Journal of Trauma·Karim BrohiJean-François Pittet
Oct 14, 2008·The Journal of Trauma·John R HessBertil Bouillon
Apr 25, 2009·Current Opinion in Anaesthesiology·Ross A Davenport, Karim Brohi
Aug 18, 2009·Transfusion·Nancy M Dunbar, Wayne L Chandler
Dec 10, 2009·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·O GrottkeR Tolba
Oct 11, 2011·Critical Care Medicine·Todd A BakerMatthias Majetschak
Oct 15, 2011·Stroke; a Journal of Cerebral Circulation·Wei ZhouRoland Veltkamp
May 29, 2012·Journal of Thrombosis and Haemostasis : JTH·M Hoffman, Y Dargaud
Jul 21, 2012·Journal of Thrombosis and Haemostasis : JTH·I PragstJ van Ryn
Sep 27, 2012·American Journal of Clinical Pathology·Joyce CurversVolkher Scharnhorst
Feb 19, 2013·Anesthesiology·Jerrold H LevyCharles M Samama
Mar 12, 2013·Blood·Felix SchieleTobias Litzenburger
Apr 23, 2013·Critical Care : the Official Journal of the Critical Care Forum·Donat R SpahnRolf Rossaint
Apr 30, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hein HeidbuchelUNKNOWN European Heart Rhythm Association
May 4, 2013·Mayo Clinic Proceedings·Wilson I GonsalvesMrinal M Patnaik
Jan 5, 2014·British Journal of Haematology·Sam SchulmanShari Ghanny
Dec 3, 2014·Anaesthesia·H SchöchlC J Schlimp
Apr 3, 2015·Thrombosis and Haemostasis·Andreas GreinacherKathleen Selleng
Jun 23, 2015·The New England Journal of Medicine·Charles V PollackJeffrey I Weitz

❮ Previous
Next ❯

Citations

Feb 14, 2016·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Jack E Ansell
Mar 30, 2017·Thrombosis Research·Viktor TauneMika Skeppholm
May 5, 2017·Journal of Pharmacy Practice·Sanjay MohanMark K Su
Dec 6, 2016·Expert Opinion on Pharmacotherapy·Bobby GouinMarc Blondon
May 5, 2017·Shock·Markus HonickelOliver Grottke
Apr 30, 2016·Critical Care : the Official Journal of the Critical Care Forum·Oliver GrottkeJohn Eikelboom
Jul 14, 2016·Medizinische Klinik, Intensivmedizin und Notfallmedizin·M Honickel, O Grottke
May 6, 2016·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·William Dager, Thaddaus Hellwig
Dec 4, 2016·Hematology·Andrew W Shih, Mark A Crowther
Sep 15, 2019·Journal of Thrombosis and Thrombolysis·Maria Cristina VedovatiCecilia Becattini
Aug 21, 2016·Critical Care : the Official Journal of the Critical Care Forum·Marcel Levi
Sep 14, 2017·Expert Review of Hematology·Mikhail S DzeshkaGregory Y H Lip
Apr 26, 2017·Internal and Emergency Medicine·Mauro MolteniPaolo Verdecchia
Jun 11, 2019·International Journal of Emergency Medicine·Maureane HoffmanJerrold H Levy
Feb 2, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Juraj SokolJan Stasko
Sep 24, 2016·Deutsches Ärzteblatt International·Marc MaegeleJürgen Koscielny

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Coagulation Signaling Pathways

Coagulation is the process by which a blood clot is formed. This process includes both the formation of a platelet plug as well as a cascade of clotting factors resulting in the formation of fibrin strands. Find the latest research on coagulation signaling pathways here.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.