Increasing concentrations of prothrombin complex concentrate induce disseminated intravascular coagulation in a pig model of coagulopathy with blunt liver injury

被引：108

作者：

Grottke, Oliver ^{[1
,2
]}

Braunschweig, Till ^{[3
]}

Spronk, Henri M. H. ^{[4
]}

Esch, Stephanie ^{[1
]}

Rieg, Annette D. ^{[1
]}

van Oerle, Rene ^{[4
]}

ten Cate, Hugo ^{[4
]}

Fitzner, Christina ^{[5
]}

Tolba, Rene ^{[2
]}

Rossaint, Rolf ^{[1
]}

机构：

[1] RWTH Aachen Univ Hosp, Dept Anesthesiol, D-52074 Aachen, Germany

[2] RWTH Aachen Univ Hosp, Inst Lab Anim Sci, D-52074 Aachen, Germany

[3] RWTH Aachen Univ Hosp, Dept Pathol, D-52074 Aachen, Germany

[4] Maastricht Univ, Lab Clin Thrombosis & Haemostasis, Cardiovasc Res Inst Maastricht, Dept Internal Med,Med Ctr, Maastricht, Netherlands

[5] RWTH Aachen Univ Hosp, Dept Med Stat, D-52074 Aachen, Germany

来源：

BLOOD | 2011年 / 118卷 / 07期

关键词：

FRESH-FROZEN PLASMA; RECOMBINANT FACTOR VIIA; DILUTIONAL COAGULOPATHY; IN-VITRO; THROMBOEMBOLIC COMPLICATIONS; THROMBIN GENERATION; SURGICAL-PATIENTS; BERIPLEX P/N; MAJOR TRAUMA; FIBRINOGEN;

D O I：

10.1182/blood-2011-03-343046

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Despite increasing use of prothrombin complex concentrate (PCC) to treat hemorrhage-associated coagulopathy, few studies have investigated PCC in trauma, and there is a particular lack of safety data. This study was performed to evaluate PCC therapy in a porcine model of coagulopathy with blunt liver injury. Coagulopathy was induced in 27 anesthetized pigs by replacing approximately 70% blood volume with hydroxyethyl starch 130/0.4 and Ringer's lactate solution; erythrocytes were collected and retransfused. Ten minutes after trauma, animals randomly received PCC (35 or 50 IU/kg) or saline. Coagulation parameters including thromboelastometry, thrombin generation, and blood loss were monitored for 2 hours. Internal organs were examined macroscopically and histologically to determine the presence of emboli and assess liver injury. Total blood loss was significantly lower and survival was higher in both PCC groups versus the control group (P < .05). These outcomes appeared to be dose-independent. Thromboembolism was found in all animals treated with 50 IU/kg PCC; 44% also showed signs of disseminated intravascular coagulation. Liver injury was similar in all animals. In conclusion, 35 IU/kg PCC safely improved coagulation and attenuated blood loss. However, the higher dose of PCC (50 IU/kg) appeared to increase the risk of thromboembolism and disseminated intravascular coagulation. (Blood. 2011;118(7):1943-1951)

引用

页码：1943 / 1951

页数：9

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