Document Detail


Influence of prothrombin complex concentrates on plasma coagulation in critically ill patients.
MedLine Citation:
PMID:  10551966     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate thrombogenicity of prothrombin complex concentrates (PCCs) in critically ill patients. DESIGN: Prospective clinical study. SETTING: Medical intensive care unit at a university hospital. PATIENTS: 16 consecutive patients suffering from acquired deficiencies of coagulation factors and with either overt bleeding from any site or a planned invasive procedure. INTERVENTIONS: 2000 factor IX units of PCCs intravenously. MEASUREMENTS AND RESULTS: Prothrombin time (PT), activated partial prothrombin time, fibrinogen, platelet count, plasma levels of coagulation factors II, V, VII, VIII, IX, X, antithrombin, protein C, thrombin-antithrombin complex (TAT), prothrombin fragment F(1+2), and the fibrin degradation product D-dimer were measured prior to and 1, 3, and 24 h after administration of PCCs. PT as well as coagulation factors II, VII, IX, and X, TAT, and F(1+2) showed a significant increase after administration of PCCs. All other parameters remained unchanged. CONCLUSIONS: Administration of PCCs induces thrombin generation. No evidence for induction of disseminated intravascular coagulation in biochemical terms could be found. When rapid correction of acquired coagulation factor disturbances is warranted, the use of PCCs seems reasonable, but the elevated risk of intravascular thrombus formation should be kept in mind.
Authors:
T Staudinger; M Frass; C Rintelen; P Quehenberger; O Wagner; B Stoiser; G J Locker; K Laczika; S Knapp; H Watzke
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  25     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1999 Oct 
Date Detail:
Created Date:  2000-01-05     Completed Date:  2000-01-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1105-10     Citation Subset:  IM    
Affiliation:
Department of Chemical Laboratory Diagnosis, University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. thomas.staudinger@akh-wien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Antithrombins / analysis
Blood Coagulation Factors / adverse effects,  analysis,  therapeutic use*
Blood Coagulation Tests
Coagulation Protein Disorders / blood*,  drug therapy*
Critical Illness
Drug Monitoring
Female
Fibrin Fibrinogen Degradation Products / analysis
Humans
Male
Middle Aged
Platelet Count
Prospective Studies
Protein C / analysis
Thrombin / analysis,  drug effects
Thrombosis / chemically induced
Chemical
Reg. No./Substance:
0/Antithrombins; 0/Blood Coagulation Factors; 0/Fibrin Fibrinogen Degradation Products; 0/Protein C; 37224-63-8/prothrombin complex concentrates; EC 3.4.21.5/Thrombin

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