| Comparison of fresh frozen plasma and prothrombin complex concentrate for the reversal of oral anticoagulants in patients undergoing cardiopulmonary bypass surgery: a randomized study. | |
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MedLine Citation:
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PMID: 20840339 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Fresh frozen plasma (FFP) and prothrombin complex concentrates (PCC) reverse oral anticoagulants. We compared PCC and FFP intraoperative administration in patients undergoing heart surgery with cardiopulmonary bypass (CPB). METHODS: Forty patients [with international normalized ratio (INR)≥ 2·1] assigned semi-urgent cardiac surgery were randomized to receive either FFP (n = 20) or PCC (n = 20). Prior to CPB, they received either 2 units of FFP or half of the PCC dose calculated according to body weight, initial INR and target INR ( ≤ 1·5). After CPB and protamine administration, patients received either another 2 units of FFP or the other half PCC dose. Additional doses were administered if INR was still too high ( ≥ 1·5). RESULTS: Fifteen minutes after CPB, more patients reached INR target with PCC (P = 0·007): 7/16 patients vs. 0/15 patients with FFP; there was no difference 1 h after CPB (6/15 patients with PCC vs. 4/15 patients with FFP reached target). Fifteen minutes after CPB, median INR (range) decreased to 1·6 (1·2-2·2) with PCC vs. 2·3 (1·5-3·5) with FFP; 1 h after CPB both groups reached similar values [1·6 (1·3-2·2) with PCC and 1·7 (1·3-2·7) with FFP]. With PCC, less patients needed additional dose (6/20) than with FFP (20/20) (P < 0·001). Both groups differed significantly on the course of factor II (P = 0·0023) and factor X (P = 0·008) over time. Dilution of coagulation factors was maximal at CPB onset. Safety was good for both groups, with only two related oozing cases with FFP. CONCLUSION: PCC reverses anticoagulation safely, faster and with less bleeding than FFP. |
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Authors:
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R Demeyere; S Gillardin; J Arnout; P F W Strengers |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Vox sanguinis Volume: 99 ISSN: 1423-0410 ISO Abbreviation: Vox Sang. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-09-15 Completed Date: 2011-01-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0413606 Medline TA: Vox Sang Country: England |
Other Details:
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Languages: eng Pagination: 251-60 Citation Subset: IM |
Copyright Information:
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© 2010 The Author(s). Vox Sanguinis © 2010 International Society of Blood Transfusion. |
Affiliation:
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Department of Anaesthesiology, University Hospital Gasthuisberg, Leuven, Belgium. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Administration, Oral Aged Aged, 80 and over Anticoagulants / administration & dosage* Blood Coagulation Factors / administration & dosage* Cardiopulmonary Bypass* Female Humans International Normalized Ratio* Male Middle Aged Plasma* |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Blood Coagulation Factors; 37224-63-8/prothrombin complex concentrates |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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