Viable Hemostasis Obtained With Prothrombin Complex Concentrate in Patients Who Refuse Standard Allogeneic Blood Transfusion and Undergo Complex Cardiac Surgery: A Case Series

Abstract

Human 4-factor prothrombin complex concentrate (4F-PCC) may reduce blood loss during surgery. This case series described perioperative outcomes among 9 patients who refused standard allogeneic blood transfusion, underwent complex cardiac surgery with aortic involvement, and received intraoperative 4F-PCC. Additional intraoperative cointerventions included protamine (n = 9), aminocaproic acid (n = 8), fibrinogen concentrate (n = 6), desmopressin (n = 6), factor VIIa (n = 2), and tranexamic acid (n = 1). Outcomes included postoperative death (n = 1), major postoperative bleeding (n = 1), deep vein thrombosis (n = 2), and ischemic stroke (n = 1). When standard allogeneic blood transfusion is refused, viable hemostasis can be obtained using 4F-PCC during complex cardiac surgeries with a high risk of bleeding.

Preparation and evaluation of aldehyde starch hemostatic microspheres crosslinked with L‐cystine dimethyl ester for ultrarapid rapid hemostasis

“…4 In addition, in medical operations involving cardiovascular surgery and liver surgery, the mortality caused by severe bleeding is also high. 5,6 Therefore, how to quickly control bleeding is a problem to be solved urgently.…”

“…If the bleeding can be effectively stopped within half an hour after being injured in a war, the survival of the wounded will be significantly increased 4 . In addition, in medical operations involving cardiovascular surgery and liver surgery, the mortality caused by severe bleeding is also high 5,6 . Therefore, how to quickly control bleeding is a problem to be solved urgently.…”