Soyuncu Secgin, Aslan Savas, Mutlu Halil, Bektas Firat
Department of Emergency Medicine, Akdeniz University School of Medicine Dumlupinar Bulvari, Antalya 07059, Turkey.
Int J Clin Exp Med. 2015 Feb 15;8(2):2778-83. eCollection 2015.
Prothrombin Complex Concentrate (PCC) for reversal of warfarin is the main therapeutic option in cases of life-threatening bleeding. Aim of the study was to investigate for using 4-factor PCC brought to the therapeutic levels of International Normalized Ratio (INR) values in cases of life-threatening bleeding in Emergency Department.
This retrospective cohort study was performed in a tertiary care university emergency department. Patients with active bleeding who were taking warfarin with INR levels of ≥1.5, and had received 4-factor prothrombin complex concentrate for treatment were included in to study.
A total of 75 patients were included in the study. The median age of the study participants was 68 (minimum 23 to maximum 87) years and 45.3% (n = 34) of them were male. INR levels was normalized all patients who were received 4-factor PCC. Red blood cell (RBC) was transfused in 16 patients (21%) because of the low hemoglobin levels. Mean unite of the RBC packet was 2,75. The lengths of hospital stay of receiving 4-factor PCC rate were determined 4.9 ± 8.7 days. No thrombotic complications or adverse drug reactions were observed after 4-factor PCC administration in any of the patients.
In our study 4-factor PCC was found to be effective and safe in rapidly reversing the effects of warfarin.
凝血酶原复合物浓缩剂(PCC)用于华法林逆转是危及生命出血情况下的主要治疗选择。本研究的目的是探讨在急诊科危及生命出血的病例中使用4因子PCC使国际标准化比值(INR)值达到治疗水平的情况。
本回顾性队列研究在一所三级护理大学急诊科进行。纳入正在服用华法林且INR水平≥1.5、有活动性出血并接受4因子凝血酶原复合物浓缩剂治疗的患者进行研究。
共75例患者纳入研究。研究参与者的中位年龄为68岁(最小23岁至最大87岁),其中45.3%(n = 34)为男性。所有接受4因子PCC的患者INR水平均恢复正常。16例患者(21%)因血红蛋白水平低而输注红细胞。红细胞包的平均单位为2.75。接受4因子PCC治疗的住院时间确定为4.9±8.7天。在任何患者中,4因子PCC给药后均未观察到血栓形成并发症或药物不良反应。
在我们的研究中,发现4因子PCC在快速逆转华法林的作用方面是有效且安全的。