Comparison of 4-Factor Prothrombin Complex Concentrate With Frozen Plasma for Management of Hemorrhage During and After Cardiac Surgery

Abstract

Key Points Question Can 4-factor prothrombin complex concentrate (PCC) be used as a substitute for frozen plasma (FP) for treatment of bleeding related to coagulation factor deficiency in cardiac surgery? Findings In this pilot trial, 101 adult patients were successfully randomized to receive PCC or FP for bleeding during cardiac surgery. In exploratory analyses, the PCC group had significantly lower chest tube blood loss and received fewer allogeneic blood transfusions, whereas the number of thromboembolic events was similar. Meaning Four-factor PCC may be a suitable alternative to FP for management of cardiac surgery–associated coagulopathy, pending assessment by adequately powered multicenter trials.