Management of patients receiving anticoagulants is a major factor in achieving better outcomes. Anticoagulant therapy may need to be discontinued or rapidly reversed before urgent surgery or invasive procedures. In these situations, treatment with concentrated vitamin K, fresh frozen plasma, and/or clotting factors can achieve more rapid anticoagulant reversal than can drug discontinuation alone. Activated prothrombin complex concentrate is used to treat hemophiliac patients with acquired factor VIII inhibitors. Nonactivated prothrombin complex concentrates are used for anticoagulant reversal. The concentrates are effective within minutes of dosing, providing a nearly immediate decrease in the international normalized ratio. The concentrates are lyophilized powders that can be quickly reconstituted, do not require ABO blood typing before use, and contain 25 times the concentration of vitamin K–dependent clotting factors compared with fresh frozen plasma. Studies suggest that the concentrates are associated with better clinical end points than is fresh frozen plasma.
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Feature| April 01 2017
Clinical Application of Prothrombin Complex Concentrate in Blood Management in Patients
Sherri Ozawa, RN;
Sherri Ozawa is the clinical director, Institute for Patient Blood Management and Bloodless Medicine and Surgery, Englewood Hospital and Medical Center, Englewood, NJ, and the executive director of the Society for the Advancement of Blood Management.
Corresponding author: Sherri Ozawa, rn, Clinical Director, Institute for Patient Blood Management and Bloodless Medicine and Surgery, Englewood Hospital and Medical Center, 350 Engle St, Englewood, NJ 07631 (e-mail: firstname.lastname@example.org).
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Crit Care Nurse (2017) 37 (2): 49–56.
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Sherri Ozawa, Tiffany Nelson; Clinical Application of Prothrombin Complex Concentrate in Blood Management in Patients. Crit Care Nurse 1 April 2017; 37 (2): 49–56. doi: https://doi.org/10.4037/ccn2017333
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