Four-Factor Prothrombin Complex Concentrate: An Indispensable Adjunct in Coagulopathy of Trauma Management - A Comparative Review of the Literature over 2 Decades.
Coagulopathy
Damage control resuscitation
Fresh-frozen plasma
Prothrombin complex concentrate
Trauma
Journal
European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes
ISSN: 1421-9921
Titre abrégé: Eur Surg Res
Pays: Switzerland
ID NLM: 0174752
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
06
2020
accepted:
01
07
2020
pubmed:
24
9
2020
medline:
14
7
2021
entrez:
23
9
2020
Statut:
ppublish
Résumé
Damage control resuscitation forms the cornerstone of management in trauma surgery. Several blood products have been widely used for preoperative transfusions prior to emergency surgeries and for hemorrhage control in trauma. Prothrombin complex concentrate (PCC) is now being introduced as an essential component of damage control resuscitation. We did a comparative descriptive analysis of several single and multi-institutional clinical trials and retrospective cohort studies. The primary focus of these studies was a comparison between PCC and other transfusion modalities including recombinant factor VIIa, fresh-frozen plasma, and fibrinogen based on several vital parameters. The parameters included rapid international normalized ratio reversal, hospital length of stay, cost-effectiveness, mortality rate, and rate of thromboembolic complications. Although still awaiting its approval from the FDA for use in traumatic coagulopathy, 4-factor PCC has shown far more convincing results in contrast to former transfusion modalities, even 3-factor PCC. However, more prospective extensive clinical trials on national levels are needed to compare its effectiveness to 3-factor PCC and gather promising recognition in the trauma care fraternity.
Sections du résumé
BACKGROUND
BACKGROUND
Damage control resuscitation forms the cornerstone of management in trauma surgery. Several blood products have been widely used for preoperative transfusions prior to emergency surgeries and for hemorrhage control in trauma. Prothrombin complex concentrate (PCC) is now being introduced as an essential component of damage control resuscitation.
SUMMARY
CONCLUSIONS
We did a comparative descriptive analysis of several single and multi-institutional clinical trials and retrospective cohort studies. The primary focus of these studies was a comparison between PCC and other transfusion modalities including recombinant factor VIIa, fresh-frozen plasma, and fibrinogen based on several vital parameters. The parameters included rapid international normalized ratio reversal, hospital length of stay, cost-effectiveness, mortality rate, and rate of thromboembolic complications.
KEY POINTS
CONCLUSIONS
Although still awaiting its approval from the FDA for use in traumatic coagulopathy, 4-factor PCC has shown far more convincing results in contrast to former transfusion modalities, even 3-factor PCC. However, more prospective extensive clinical trials on national levels are needed to compare its effectiveness to 3-factor PCC and gather promising recognition in the trauma care fraternity.
Identifiants
pubmed: 32966972
pii: 000509876
doi: 10.1159/000509876
doi:
Substances chimiques
Blood Coagulation Factors
0
Recombinant Proteins
0
prothrombin complex concentrates
37224-63-8
Types de publication
Comparative Study
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
51-61Informations de copyright
© 2020 S. Karger AG, Basel.