Outcomes Following Three-Factor Inactive Prothrombin Complex Concentrate Versus Recombinant Activated Factor VII Administration During Cardiac Surgery

Effectiveness of prothrombin complex concentrate for the treatment of bleeding: A systematic review and meta‐analysis

“…Of these, full text was assessed, leading to the exclusion of another 109 studies, resulting in 17 studies that were included in the analysis. Studies included two prospective studies 23,24 and 15 retrospective studies, 25‐39 yielding a total of 3060 patients (Figure 1). Characteristics of the included studies are shown in Table 1.…”

“…The most frequent comparator to PCC was FFP with two studies investigating PCC only in comparison to FFP only 23,36 and nine studies investigating a combination of PCC and FFP in comparison to FFP only 24,26,28,31‐34,38,39 . Other comparators included rFVII, which was compared with PCC in four studies 27,29,35,37 . In one study that was conducted in Jehovah's Witness patients, the comparator consisted of not giving any coagulation factor or transfusion product, 30 and in one study the comparator was standard care that was not further specified 25 .…”

“…The PCC product that was mostly evaluated was 4‐factor PCC (nine studies), 12,26‐28,31,34‐36,38 whereas 3‐factor PCC was evaluated in seven studies 23,25,29,32,33,37,39 . Multiple types of PCC were used in one study 24 .…”

“…In 13 studies, PCC was administered based on clinical judgment 24‐27,29‐33,35,37‐39 . In four studies, PCC administration was protocolized, usually guided by thromboelastometry 27,29,31,32 . A summary regarding PCC type, dose, and setting can be found in the supplement (Table S1).…”

Comparing Factor Concentrates for Post-Bypass Coagulopathy: Is There One Best Option?

“…Given the limited data on direct comparisons of any of the factor concentrates, Harper and colleagues look to further expand our understanding of the efficacy and adverse outcomes associated with PCC and rFVIIa. 16 In this current issue of the Journal of Cardiothoracic and Vascular Anesthesia, they perform a retrospective analysis of 3-factor PCC (Bebulin, Baxalta US Inc, Westlake Village, CA) and rFVIIa (NovoSeven RT, Novo Nordisk A/S, Bagsvaerd, Denmark) in patients undergoing cardiac surgery with cardiopulmonary bypass. Review of medical records from January 2003 to April 2015 revealed 72 patients that received 3-factor PCC and 263 patients that received rFVIIa.…”