| Prothrombin complex concentrate mitigates diffuse bleeding after cardiopulmonary bypass in a porcine model. | |
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MedLine Citation:
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PMID: 20716565 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Extracorporeal circuit priming and intravascular volume expansion during cardiopulmonary bypass (CPB) may lead to dilutional coagulopathy and excessive diffuse postoperative bleeding. Prothrombin complex concentrate (PCC) containing clotting factors II (FII), VII (FVII), IX (FIX), and X (FX) could be of potential value in correcting dilutional coagulopathy and reducing blood loss. METHODS: Anaesthetized pigs underwent CPB with hypothermia for 2 h at 25°C followed by 1 h of normothermia. Approximately 1 h after CPB, animals randomly received either isotonic saline 1 ml kg⁻¹ or PCC 30 IU kg⁻¹ in a volume of 1 ml kg⁻¹. Diffuse coagulopathic bleeding was assessed as suture hole blood loss from a Gore-Tex patch placed over a full-thickness incision in the left carotid artery. RESULTS: After CPB, levels of FII, FVII, FIX, and FX declined from baseline by 32% to 48%, and PCC fully or partially reversed those deficits. Median suture hole blood loss after administration of saline placebo was 74 ml. PCC reduced suture hole bleeding by a median of 54 ml with a 95% confidence interval of 6-112 ml (P=0.026) compared with saline. PCC, but not saline, normalized skin bleeding time. Peak thrombin generation markedly decreased after CPB, but then returned in PCC-treated animals to a level higher than baseline by 28.7 nM (14.5-41.1 nM; P=0.031). CONCLUSIONS: PCC was effective in correcting dilutional coagulopathy and reducing diffuse bleeding in an in vivo large-animal CPB model. Further research is warranted on PCC as a haemostatic agent in CPB. |
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Authors:
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F Kaspereit; S Hoffmann; I Pragst; G Dickneite |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2010-08-17 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 105 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-10-18 Completed Date: 2010-11-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 576-82 Citation Subset: IM |
Affiliation:
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Department of Preclinical Research and Development, CSL Behring GmbH, Marburg, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Coagulation Disorders / blood, drug therapy, etiology Blood Coagulation Factors / metabolism, therapeutic use* Cardiopulmonary Bypass / adverse effects* Coagulants / therapeutic use* Disease Models, Animal Drug Evaluation, Preclinical / methods Hemostasis, Surgical / methods Male Postoperative Hemorrhage / blood, etiology, prevention & control* Prothrombin Time Sus scrofa Thrombin / biosynthesis |
| Chemical | |
Reg. No./Substance:
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0/Blood Coagulation Factors; 0/Coagulants; 37224-63-8/prothrombin complex concentrates; EC 3.4.21.5/Thrombin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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