title: Clinical Application of Prothrombin Complex Concentrate in Blood Management in Patients.
abstract: Management of patients receiving anticoagulants is a major factor in achieving better outcomes. Anticoagulant therapy may need to be discontinued or rapidly reversed before urgent surgery or invasive procedures. In these situations, treatment with concentrated vitamin K, fresh frozen plasma, and/or clotting factors can achieve more rapid anticoagulant reversal than can drug discontinuation alone. Activated prothrombin complex concentrate is used to treat hemophiliac patients with acquired factor VIII inhibitors. Nonactivated prothrombin complex concentrates are used for anticoagulant reversal. The concentrates are effective within minutes of dosing, providing a nearly immediate decrease in the international normalized ratio. The concentrates are lyophilized powders that can be quickly reconstituted, do not require ABO blood typing before use, and contain 25 times the concentration of vitamin K-dependent clotting factors compared with fresh frozen plasma. Studies suggest that the concentrates are associated with better clinical end points than is fresh frozen plasma.
authors.affiliation: Sherri Ozawa is the clinical director, Institute for Patient Blood Management and Bloodless Medicine and Surgery, Englewood Hospital and Medical Center, Englewood, NJ, and the executive director of the Society for the Advancement of Blood Management. sherri.ozawa@ehmc.com.|Tiffany Nelson is the clinical director, patient blood management, and the transfusion safety officer for the Florida Hospital System, Orlando, Florida. sherri.ozawa@ehmc.com.
authors.forename: Sherri
authors.initials: S
authors.lastname: Ozawa
authors.affiliation: Sherri Ozawa is the clinical director, Institute for Patient Blood Management and Bloodless Medicine and Surgery, Englewood Hospital and Medical Center, Englewood, NJ, and the executive director of the Society for the Advancement of Blood Management.|Tiffany Nelson is the clinical director, patient blood management, and the transfusion safety officer for the Florida Hospital System, Orlando, Florida.
authors.forename: Tiffany
authors.initials: T
authors.lastname: Nelson
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D001779:Blood Coagulation Factors / Q000627:therapeutic use*; D001803:Blood Transfusion; D005260:Female; D006467:Hemophilia A / Q000628:therapy*; D006470:Hemorrhage / Q000517:prevention & control*; D006801:Humans; D008297:Male; D010949:Plasma; D014812:Vitamin K / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; D014812:Vitamin K