Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Harvard

Erdoes, G, Ortmann, E, Meesters, MI, Bolliger, D, Baryshnikova, E, Martinez Lopez De Arroyabe, B, Ahmed, A, Lance, MD, Ranucci, M, von Heymann, C, Agarwal, S & Ravn, HB 2021, 'A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients', Anaesthesia, bind 76, nr. 3, s. 381-392. https://doi.org/10.1111/anae.15181

APA

Erdoes, G., Ortmann, E., Meesters, M. I., Bolliger, D., Baryshnikova, E., Martinez Lopez De Arroyabe, B., Ahmed, A., Lance, M. D., Ranucci, M., von Heymann, C., Agarwal, S., & Ravn, H. B. (2021). A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients. Anaesthesia, 76(3), 381-392. https://doi.org/10.1111/anae.15181

CBE

Erdoes G, Ortmann E, Meesters MI, Bolliger D, Baryshnikova E, Martinez Lopez De Arroyabe B, Ahmed A, Lance MD, Ranucci M, von Heymann C, Agarwal S, Ravn HB. 2021. A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients. Anaesthesia. 76(3):381-392. https://doi.org/10.1111/anae.15181

MLA

Vancouver

Erdoes G, Ortmann E, Meesters MI, Bolliger D, Baryshnikova E, Martinez Lopez De Arroyabe B o.a. A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients. Anaesthesia. 2021 mar;76(3):381-392. https://doi.org/10.1111/anae.15181

Author

Erdoes, G ; Ortmann, E ; Meesters, M I ; Bolliger, D ; Baryshnikova, E ; Martinez Lopez De Arroyabe, B ; Ahmed, A ; Lance, M D ; Ranucci, M ; von Heymann, C ; Agarwal, S ; Ravn, H B. / A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients. I: Anaesthesia. 2021 ; Bind 76, Nr. 3. s. 381-392.

Bibtex

@article{c7018a69f8af4af0a97590c4004ac09d,
title = "A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients",
abstract = "Modern four-factor prothrombin complex concentrate was designed originally for rapid targeted replacement of the coagulation factors II, VII, IX and X. Dosing strategies for the approved indication of vitamin K antagonist-related bleeding vary greatly. They include INR and bodyweight-related protocols as well as fixed dose regimens. Particularly in the massively bleeding trauma and cardiac surgery patient, four-factor prothrombin complex concentrate is used increasingly for haemostatic resuscitation. Members of the Transfusion and Haemostasis Subcommittee of the European Association of Cardiothoracic Anaesthesiology performed a systematic literature review on four-factor prothrombin complex concentrate. The available evidence has been summarised for dosing, efficacy, drug safety and monitoring strategies in different scenarios. Whereas there is evidence for the efficacy of four-factor prothrombin concentrate for a variety of bleeding scenarios, convincing safety data are clearly missing. In the massively bleeding patient with coagulopathy, our group recommends the administration of an initial bolus of 25 IU.kg-1 . This applies for: the acute reversal of vitamin K antagonist therapy; haemostatic resuscitation, particularly in trauma; and the reversal of direct oral anticoagulants when no specific antidote is available. In patients with a high risk for thromboembolic complications, e.g. cardiac surgery, the administration of an initial half-dose bolus (12.5 IU.kg-1 ) should be considered. A second bolus may be indicated if coagulopathy and microvascular bleeding persists and other reasons for bleeding are largely ruled out. Tissue-factor-activated, factor VII-dependent and heparin insensitive point-of-care tests may be used for peri-operative monitoring and guiding of prothrombin complex concentrate therapy.",
keywords = "cardiac surgery, dosing, efficacy, monitoring, non-cardiac surgery, prothrombin complex concentrate, safety, trauma, vitamin K antagonist therapy",
author = "G Erdoes and E Ortmann and Meesters, {M I} and D Bolliger and E Baryshnikova and {Martinez Lopez De Arroyabe}, B and A Ahmed and Lance, {M D} and M Ranucci and {von Heymann}, C and S Agarwal and Ravn, {H B}",
note = "{\textcopyright} 2020 Association of Anaesthetists.",
year = "2021",
month = mar,
doi = "10.1111/anae.15181",
language = "English",
volume = "76",
pages = "381--392",
journal = "Anaesthesia",
issn = "0003-2409",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "3",

}

RIS

TY - JOUR

T1 - A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients

AU - Erdoes, G

AU - Ortmann, E

AU - Meesters, M I

AU - Bolliger, D

AU - Baryshnikova, E

AU - Martinez Lopez De Arroyabe, B

AU - Ahmed, A

AU - Lance, M D

AU - Ranucci, M

AU - von Heymann, C

AU - Agarwal, S

AU - Ravn, H B

N1 - © 2020 Association of Anaesthetists.

PY - 2021/3

Y1 - 2021/3

N2 - Modern four-factor prothrombin complex concentrate was designed originally for rapid targeted replacement of the coagulation factors II, VII, IX and X. Dosing strategies for the approved indication of vitamin K antagonist-related bleeding vary greatly. They include INR and bodyweight-related protocols as well as fixed dose regimens. Particularly in the massively bleeding trauma and cardiac surgery patient, four-factor prothrombin complex concentrate is used increasingly for haemostatic resuscitation. Members of the Transfusion and Haemostasis Subcommittee of the European Association of Cardiothoracic Anaesthesiology performed a systematic literature review on four-factor prothrombin complex concentrate. The available evidence has been summarised for dosing, efficacy, drug safety and monitoring strategies in different scenarios. Whereas there is evidence for the efficacy of four-factor prothrombin concentrate for a variety of bleeding scenarios, convincing safety data are clearly missing. In the massively bleeding patient with coagulopathy, our group recommends the administration of an initial bolus of 25 IU.kg-1 . This applies for: the acute reversal of vitamin K antagonist therapy; haemostatic resuscitation, particularly in trauma; and the reversal of direct oral anticoagulants when no specific antidote is available. In patients with a high risk for thromboembolic complications, e.g. cardiac surgery, the administration of an initial half-dose bolus (12.5 IU.kg-1 ) should be considered. A second bolus may be indicated if coagulopathy and microvascular bleeding persists and other reasons for bleeding are largely ruled out. Tissue-factor-activated, factor VII-dependent and heparin insensitive point-of-care tests may be used for peri-operative monitoring and guiding of prothrombin complex concentrate therapy.

AB - Modern four-factor prothrombin complex concentrate was designed originally for rapid targeted replacement of the coagulation factors II, VII, IX and X. Dosing strategies for the approved indication of vitamin K antagonist-related bleeding vary greatly. They include INR and bodyweight-related protocols as well as fixed dose regimens. Particularly in the massively bleeding trauma and cardiac surgery patient, four-factor prothrombin complex concentrate is used increasingly for haemostatic resuscitation. Members of the Transfusion and Haemostasis Subcommittee of the European Association of Cardiothoracic Anaesthesiology performed a systematic literature review on four-factor prothrombin complex concentrate. The available evidence has been summarised for dosing, efficacy, drug safety and monitoring strategies in different scenarios. Whereas there is evidence for the efficacy of four-factor prothrombin concentrate for a variety of bleeding scenarios, convincing safety data are clearly missing. In the massively bleeding patient with coagulopathy, our group recommends the administration of an initial bolus of 25 IU.kg-1 . This applies for: the acute reversal of vitamin K antagonist therapy; haemostatic resuscitation, particularly in trauma; and the reversal of direct oral anticoagulants when no specific antidote is available. In patients with a high risk for thromboembolic complications, e.g. cardiac surgery, the administration of an initial half-dose bolus (12.5 IU.kg-1 ) should be considered. A second bolus may be indicated if coagulopathy and microvascular bleeding persists and other reasons for bleeding are largely ruled out. Tissue-factor-activated, factor VII-dependent and heparin insensitive point-of-care tests may be used for peri-operative monitoring and guiding of prothrombin complex concentrate therapy.

KW - cardiac surgery

KW - dosing

KW - efficacy

KW - monitoring

KW - non-cardiac surgery

KW - prothrombin complex concentrate

KW - safety

KW - trauma

KW - vitamin K antagonist therapy

UR - http://www.scopus.com/inward/record.url?scp=85088011328&partnerID=8YFLogxK

U2 - 10.1111/anae.15181

DO - 10.1111/anae.15181

M3 - Journal article

C2 - 32681570

VL - 76

SP - 381

EP - 392

JO - Anaesthesia

JF - Anaesthesia

SN - 0003-2409

IS - 3

ER -

ID: 61098863