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- Elvstam, OlofLund University,Lunds universitet,Klinisk infektionsmedicin,Forskargrupper vid Lunds universitet,Clinical infection medicine,Lund University Research Groups (author)
ROTEM monitoring of activated and non-activated prothrombin complex concentrate correction of dilutional coagulopathy.
- Article/chapterEnglish2016
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- 2016-02-22
- Informa UK Limited,2016
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- LIBRIS-ID:oai:lup.lub.lu.se:0ae72a8d-9e49-4157-aabf-2be7de84613c
- https://lup.lub.lu.se/record/8824969URI
- https://doi.org/10.3109/00365513.2015.1137347DOI
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- Language:English
- Summary in:English
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- Objectives Prothrombin complex concentrates have been used to correct dilutional coagulopathy, but many preparations contain anticoagulants, such as heparin, to counteract their prothrombotic effects. These anticoagulants can interfere with haemostatic assays. The aim of this study was to monitor two different prothrombin complex concentrates for the treatment of albumin dilution in vitro, using rotational thromboelastometry with or without the heparin-antagonising agent protamine. Methods Citrated blood from 10 healthy volunteers was, in vitro, diluted 1:1 with 5% albumin and then corrected with a four-factor prothrombin complex concentrate with heparin anticoagulant (Confidex®) corresponding to a clinical dose of 43 IU/kg. Blood samples were tested with or without protamine. An activated prothrombin complex concentrate (APCC) (FEIBA®) without heparin in doses of 50 IU/kg and 100 IU/kg was also tested. Thromboelastometry was performed after recalcification. Results Albumin dilution significantly affected all thromboelastometry parameters. The four-factor PCC had an additional anticoagulant effect when added to the albumin-diluted blood; it was partially corrected by protamine for all parameters except maximum clot firmness. The APCC significantly improved all parameters, with over-correction of clotting time but only partial correction of maximum clot firmness. Conclusions The anticoagulant content of many prothrombin complex concentrates needs to be considered when performing in vitro testing. A heparin-free APCC better corrected an in vitro albumin-induced dilutional coagulopathy than a four-factor PCC, despite of blocking heparin with protamine.
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- Berntorp, ErikLund University,Lunds universitet,Klinisk koagulationsmedicin, Malmö,Forskargrupper vid Lunds universitet,Clinical Coagulation, Malmö,Lund University Research Groups(Swepub:lu)medf-ebe (author)
- Schött, UlfLund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk forskning inom anestesi och intensivvårdsmedicin,Forskargrupper vid Lunds universitet,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Research in Anaesthesia and Intensive Care Medicine,Lund University Research Groups(Swepub:lu)med-ush (author)
- Klinisk infektionsmedicinForskargrupper vid Lunds universitet (creator_code:org_t)
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- In:Scandinavian Journal of Clinical and Laboratory Investigation: Informa UK Limited76:3, s. 202-2071502-76860036-5513
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