Safety and efficacy of prothrombin complex concentrates for the treatment of coagulopathy after cardiac surgery

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35 Citations (Scopus)

Abstract

Objective: Coagulopathy is an important cause of bleeding after complex cardiac surgery. The conventional treatment for coagulopathy is transfusion, which is associated with adverse outcomes. We report our initial experience with the prothrombin complex concentrate FEIBA (factor VIII inhibitor bypassing activity) for the rescue treatment of coagulopathy and life-threatening bleeding after cardiac surgery. Methods: Twenty-five patients who underwent cardiac surgery with coagulopathy and life-threatening bleeding refractory to conventional treatment received FEIBA as rescue therapy at our institution. This cohort represents approximately 2% of patients undergoing cardiac surgery in our university-based practice during the study. Results: The patients were at high risk for postoperative coagulopathy with nearly all patients having at least 2 risk factors for this. Aortic root replacement (Bentall or valve-sparing procedure) and heart transplant with or without left ventricular assist device explant were the most common procedures. The mean FEIBA dose was 2154 units. The need for fresh frozen plasma and platelet transfusion decreased significantly after FEIBA administration (P =.0001 and P

Original languageEnglish (US)
Pages (from-to)1036-1040
Number of pages5
JournalJournal of Thoracic and Cardiovascular Surgery
Volume147
Issue number3
DOIs
StatePublished - Mar 2014

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Thoracic Surgery
Safety
Hemorrhage
Platelet Transfusion
Heart-Assist Devices
Factor VIII
Therapeutics
Transplants
prothrombin complex concentrates

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

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title = "Safety and efficacy of prothrombin complex concentrates for the treatment of coagulopathy after cardiac surgery",
abstract = "Objective: Coagulopathy is an important cause of bleeding after complex cardiac surgery. The conventional treatment for coagulopathy is transfusion, which is associated with adverse outcomes. We report our initial experience with the prothrombin complex concentrate FEIBA (factor VIII inhibitor bypassing activity) for the rescue treatment of coagulopathy and life-threatening bleeding after cardiac surgery. Methods: Twenty-five patients who underwent cardiac surgery with coagulopathy and life-threatening bleeding refractory to conventional treatment received FEIBA as rescue therapy at our institution. This cohort represents approximately 2{\%} of patients undergoing cardiac surgery in our university-based practice during the study. Results: The patients were at high risk for postoperative coagulopathy with nearly all patients having at least 2 risk factors for this. Aortic root replacement (Bentall or valve-sparing procedure) and heart transplant with or without left ventricular assist device explant were the most common procedures. The mean FEIBA dose was 2154 units. The need for fresh frozen plasma and platelet transfusion decreased significantly after FEIBA administration (P =.0001 and P",
author = "Howard Song and Tibayan, {Frederick (Fred)} and Kahl, {Edward (Ed)} and Valerie Sera and Matthew Slater and Thomas Deloughery and Scanlan, {Mick M.}",
year = "2014",
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language = "English (US)",
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pages = "1036--1040",
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TY - JOUR

T1 - Safety and efficacy of prothrombin complex concentrates for the treatment of coagulopathy after cardiac surgery

AU - Song, Howard

AU - Tibayan, Frederick (Fred)

AU - Kahl, Edward (Ed)

AU - Sera, Valerie

AU - Slater, Matthew

AU - Deloughery, Thomas

AU - Scanlan, Mick M.

PY - 2014/3

Y1 - 2014/3

N2 - Objective: Coagulopathy is an important cause of bleeding after complex cardiac surgery. The conventional treatment for coagulopathy is transfusion, which is associated with adverse outcomes. We report our initial experience with the prothrombin complex concentrate FEIBA (factor VIII inhibitor bypassing activity) for the rescue treatment of coagulopathy and life-threatening bleeding after cardiac surgery. Methods: Twenty-five patients who underwent cardiac surgery with coagulopathy and life-threatening bleeding refractory to conventional treatment received FEIBA as rescue therapy at our institution. This cohort represents approximately 2% of patients undergoing cardiac surgery in our university-based practice during the study. Results: The patients were at high risk for postoperative coagulopathy with nearly all patients having at least 2 risk factors for this. Aortic root replacement (Bentall or valve-sparing procedure) and heart transplant with or without left ventricular assist device explant were the most common procedures. The mean FEIBA dose was 2154 units. The need for fresh frozen plasma and platelet transfusion decreased significantly after FEIBA administration (P =.0001 and P

AB - Objective: Coagulopathy is an important cause of bleeding after complex cardiac surgery. The conventional treatment for coagulopathy is transfusion, which is associated with adverse outcomes. We report our initial experience with the prothrombin complex concentrate FEIBA (factor VIII inhibitor bypassing activity) for the rescue treatment of coagulopathy and life-threatening bleeding after cardiac surgery. Methods: Twenty-five patients who underwent cardiac surgery with coagulopathy and life-threatening bleeding refractory to conventional treatment received FEIBA as rescue therapy at our institution. This cohort represents approximately 2% of patients undergoing cardiac surgery in our university-based practice during the study. Results: The patients were at high risk for postoperative coagulopathy with nearly all patients having at least 2 risk factors for this. Aortic root replacement (Bentall or valve-sparing procedure) and heart transplant with or without left ventricular assist device explant were the most common procedures. The mean FEIBA dose was 2154 units. The need for fresh frozen plasma and platelet transfusion decreased significantly after FEIBA administration (P =.0001 and P

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