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Prothrombin complex concentrates: a brief review

Published online by Cambridge University Press:  01 October 2008

C. M. Samama*
Affiliation:
Hotel-Dieu University Hospital, Department of Anaesthesiology and Intensive Care, Paris Cedex, France
*
Correspondence to: Charles Marc Samama, Department of Anaesthesiology and Intensive Care, Hotel-Dieu University Hospital, 1, Place du Parvis de Notre-Dame, 75181 Paris Cedex 04, France. E-mail: marc.samama@htd.aphp.fr; Tel: +33 1 42 34 85 51; Fax: +33 1 42 34 89 60
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Summary

Prothrombin complex concentrates are haemostatic blood products containing four vitamin K-dependent clotting factors (II, VII, IX and X). They are a useful, reliable and fast alternative to fresh frozen plasma for the reversal of the effects of oral anticoagulant treatments (vitamin K antagonists). They are sometimes used for factor II or factor X replacement in patients with congenital or acquired deficiencies. They are widely prescribed in Europe. Several retrospective and prospective studies have demonstrated their efficacy in normalizing coagulation and in helping to control life-threatening bleeding. Few side-effects, mainly thromboembolic events, have been reported. The link between these events and prothrombin complex concentrate infusion has, however, often been brought into question. The use of prothrombin complex concentrates in new promising indications such as the management of massive bleeding requires prospective studies providing a high level of evidence in a high-risk setting.

Type
Review
Copyright
Copyright © European Society of Anaesthesiology 2008

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