A retrospective audit of the use of Prothrombinex-HT for refractory bleeding following adult cardiac surgery.
OBJECTIVE
To review the frequency of use, possible efficacy and safety profile of Prothrombinex-HT (CSL Bioplasma, Melbourne, VIC) in treatment of patients with microvascular bleeding refractory to standard measures after cardiothoracic surgery.


METHODS
A retrospective chart review was performed of 60 consecutive cardiothoracic surgical patients who received Prothrombinex-HT between February and August 2003. Data collected included baseline demographic information, nature and complexity of surgery, preoperative medications, baseline haematological parameters and evidence of clinically significant prothrombotic complications. Consumption of blood products, haematological parameters and mediastinal bleeding rates before and after administration of Prothrombinex-HT were documented in 22 patients who received Prothrombinex-HT in the ICU.


RESULTS
No major prothrombotic complications were noted in the series of 60 patients. Two patients had superficial thrombophlebitis. Blood product consumption and haematological parameters were markedly reduced after administering Prothrombinex-HT.


CONCLUSIONS
Use of Prothrombinex-HT was not associated with significant prothrombotic complications. Limited evidence of its efficacy suggests that it should be further evaluated in the setting of cardiothoracic surgery.
Fraser
Todd A
TA
Department of Intensive Care Medicine, The Geelong Hospital, Geelong, VIC, Australia.
Corke
Charlie F
CF
Mohajeri
Morteza
M
Stevenson
Lisa
L
Campbell
Philip J
PJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D013504:Cardiovascular Surgical Procedures; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies
D001779:Blood Coagulation Factors; D006490:Hemostatics; C025667:prothrombin complex concentrates