1. Viable Hemostasis Obtained With Prothrombin Complex Concentrate in Patients Who Refuse Standard Allogeneic Blood Transfusion and Undergo Complex Cardiac Surgery: A Case Series
- Author
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Elsie Rizk, Eric Salazar, Elizabeth Herrera, Joshua T. Swan, Jessica Varisco, Jesse E. Harris, Kirk Heyne, and Tomona Iso
- Subjects
Hemostasis ,medicine.medical_specialty ,business.industry ,Deep vein ,Hematopoietic Stem Cell Transplantation ,General Medicine ,Perioperative ,Postoperative Hemorrhage ,medicine.disease ,Thrombosis ,Prothrombin complex concentrate ,Blood Coagulation Factors ,Surgery ,Cardiac surgery ,medicine.anatomical_structure ,medicine ,Humans ,Blood Transfusion ,Cardiac Surgical Procedures ,Aminocaproic acid ,business ,Tranexamic acid ,medicine.drug - Abstract
Human 4-factor prothrombin complex concentrate (4F-PCC) may reduce blood loss during surgery. This case series described perioperative outcomes among 9 patients who refused standard allogeneic blood transfusion, underwent complex cardiac surgery with aortic involvement, and received intraoperative 4F-PCC. Additional intraoperative cointerventions included protamine (n = 9), aminocaproic acid (n = 8), fibrinogen concentrate (n = 6), desmopressin (n = 6), factor VIIa (n = 2), and tranexamic acid (n = 1). Outcomes included postoperative death (n = 1), major postoperative bleeding (n = 1), deep vein thrombosis (n = 2), and ischemic stroke (n = 1). When standard allogeneic blood transfusion is refused, viable hemostasis can be obtained using 4F-PCC during complex cardiac surgeries with a high risk of bleeding.
- Published
- 2020
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