Perioperative use of prothrombin complex concentrates.

摘要: Prothrombin complex concentrates (PCCs) are purified drug products with hemostatic activity derived from a plasma pool. Today, PCCs contain given and proportional amount of four non-activated vitamin K-dependent coagulation factors (II, VII, IX, X), variable anticoagulant proteins (proteins C S, in some antithrombin) low-dose heparin. In countries PCC contained only three clotting factors, II, X. Dosage recommendations based on IU F-IX, so that one F-IX represents the 1 mL plasma. Reversion effect K antagonists (VKAs) cases symptomatic overdose, active bleeding episodes, or need for emergency surgery is most important indication this appears to be more complete rapid than caused by administration fresh frozen They may considered as safe preparations if they used their approved indications at recommended dosage adequate precautions administration, have been shown effective reversing VKAs. Their use decision algorithms perioperative setting allows normalization International Normalized Ratio (INR) performing surgery, minimizing risk. This review aims propose two setting, calculate dose administered patient and/or immediately before urgent patient's clinical status, prior INR target another action oral anticoagulants depending urgency surgery.