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Different Heparin Contents in Prothrombin Complex Concentrates May Impair Blood Clotting in Outpatients With Ventricular Assist Devices Receiving Phenprocoumon

Objectives Prothrombin complex concentrates (PCCs) are used to rapidly reverse anticoagulation by oral vitamin K antagonists. They differ in the content of clotting factors, endogenous anticoagulants, and heparin. The authors hypothesized that PCCs’ specific heparin content may compromise the hemost...

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Bibliographic Details
Published in:Journal of cardiothoracic and vascular anesthesia 2016-01, Vol.30 (1), p.96-101
Main Authors: Felli, Alessia, MD, Zeidler, Petra, MD, Jilma, Bernd, MD, Opfermann, Philipp, MD, Holaubek, Caroline, MD, Zimpfer, Daniel, MD, Wadowski, Patricia P., MD, Steinlechner, Barbara, MD
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Language:English
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Summary:Objectives Prothrombin complex concentrates (PCCs) are used to rapidly reverse anticoagulation by oral vitamin K antagonists. They differ in the content of clotting factors, endogenous anticoagulants, and heparin. The authors hypothesized that PCCs’ specific heparin content may compromise the hemostatic effect. Design Prospective ex-vivo investigation. Setting University hospital. Participants Venous blood samples were obtained from 8 patients with implanted ventricular assist devices who also were receiving phenprocoumon. Interventions Four different 4-factor PCCs were added to patient blood to attain a calculated increase in prothrombin time by 20%, 40%, and 60% greater than baseline in paired experiments. Measurements and Main Results Clotting was measured using thromboelastometry and endogenous thrombin potential. Two heparin-containing PCCs prolonged the clotting times in a concentration-dependent manner compared with baseline (p
ISSN:1053-0770
1532-8422
DOI:10.1053/j.jvca.2015.08.012