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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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Published in: | Journal of cardiothoracic and vascular anesthesia 2016-01, Vol.30 (1), p.96-101 |
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Main Authors: | , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
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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 |
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ISSN: | 1053-0770 1532-8422 |
DOI: | 10.1053/j.jvca.2015.08.012 |