Prothrombin Complex Concentrate Shows Superior Efficacy Over Frozen Plasma in Cardiac Surgery Bleeding, reveals research
Researchers have discovered in a new study published in JAMA that prothrombin complex concentrate (PCC) has greater hemostatic effectiveness and safety benefits compared to frozen plasma for the treatment of coagulopathic bleeding during cardiac surgery. Bleeding that is excessive is a common and dangerous complication in cardiac surgery and is frequently accompanied by the need for replacement of coagulation factors. A recent study involving 12 US and Canadian hospitals identified that the use of PCC was associated with improved hemostatic response, fewer blood transfusions, and fewer serious adverse events. The study was conducted by Keyvan K. and colleagues.
The unblinded, noninferiority controlled, randomized clinical trial randomized 538 adults (≥18 years) undergoing coagulopathic bleeding after cardiopulmonary bypass. The trial took place from November 30, 2022, through May 28, 2024, and final follow-ups were done on June 28, 2024. Participants were allocated to two groups: 265 received PCC and 263 received frozen plasma. Dosing was based on weight, with PCC given at 1500 IU for patients ≤60 kg and 2000 IU for patients >60 kg, and frozen plasma given at 3 units for patients ≤60 kg and 4 units for patients >60 kg. Doses were allowed to be repeated within 24 hours, but only frozen plasma could be repeated after that time.
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