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Influence of prothrombin complex concentrates on plasma coagulation in critically ill patients

1999; Springer Science+Business Media; Volume: 25; Issue: 10 Linguagem: Inglês

10.1007/s001340051019

1432-1238

Thomas Staudinger, Michael Frass, C. Rintelen, Peter Quehenberger, Oswald Wagner, Brigitte Stoiser, Gottfried J. Locker, Klaus Laczika, Sylvia Knapp, Herbert Watzke,

Blood properties and coagulation

To evaluate thrombogenicity of prothrombin complex concentrates (PCCs) in critically ill patients.Prospective clinical study.Medical intensive care unit at a university hospital.16 consecutive patients suffering from acquired deficiencies of coagulation factors and with either overt bleeding from any site or a planned invasive procedure.2000 factor IX units of PCCs intravenously.Prothrombin time (PT), activated partial prothrombin time, fibrinogen, platelet count, plasma levels of coagulation factors II, V, VII, VIII, IX, X, antithrombin, protein C, thrombin-antithrombin complex (TAT), prothrombin fragment F(1+2), and the fibrin degradation product D-dimer were measured prior to and 1, 3, and 24 h after administration of PCCs. PT as well as coagulation factors II, VII, IX, and X, TAT, and F(1+2) showed a significant increase after administration of PCCs. All other parameters remained unchanged.Administration of PCCs induces thrombin generation. No evidence for induction of disseminated intravascular coagulation in biochemical terms could be found. When rapid correction of acquired coagulation factor disturbances is warranted, the use of PCCs seems reasonable, but the elevated risk of intravascular thrombus formation should be kept in mind.