Prothrombin Complex Concentrates in Post-traumatic Hemorrhage: A Review
Trauma is an everlasting challenge to public health worldwide, and hemorrhage
is the most common cause of potentially preventable death among victims of trauma.
More specifically, one in every two deaths within the first day following injury result from
hemorrhage and hemorrhagic shock can lead to post-resuscitation
organ failure and related mortality.
Acquired deficiencies related to coagulation cascade are
also blamed for the death toll among patients exposed to traumatic injuries.
Alterations in prothrombin time (PT) and partial thromboplastin time (PTT) in trauma
victims were described first in 2003.
These disturbed levels in laboratory correlated with increased mortality
and effectively changed the approach to trauma care nowadays.
Contemporary damage control resuscitation encompasses ratio-based transfusion
of packed red blood cells, plasma and platelets. Although this approach is still
viewed as the “gold standard” of trauma care, goal-directed algorithms directed by
coagulation tests or viscoelastic studies may allow a better definition of any given patient’s coagulopathy.
This strategy will allow a more individualized and targeted treatment modality.
Prothrombin complex concentrate (PCC) are also advocated in many types of
coagulopathy, especially those induced by drugs such as vitamin K
antagonist (VKA) and direct oral anticoagulants.
The objective of this research is to highlight the usage characteristics and effects of PCC in trauma-induced coagulopathy (TIC). This article is a review and analysis of the most recent
literature to analyse consequences, and intended effects associated
with this treatment modality in TIC.
Emerg Med Open J. 2019; 5(1): 1-8. doi: 10.17140/EMOJ-5-152
