Impaired platelet-dependent thrombin generation associated with thrombocytopenia is improved by prothrombin complex concentrates in vitro.

摘要: Background Impaired thrombin generation (TG) in patients with acquired coagulopathy, is due to low coagulation factors and thrombocytopenia. The latter typically treated platelet transfusions the former plasma occasionally prothrombin complex concentrates (PCCs). We hypothesized that manipulating concentrations of might result restoration platelet-dependent TG over above simple replacement therapy. Objective To investigate influence PCCs on impaired secondary Methods was evaluated by assay using a thrombocytopenia model which normal samples varying counts (20-300 × 109/L) were spiked (25%-150% increase PCC levels). Results platelets significantly increased dose-dependent manner vitro. Two-way repeated measures analysis variance showed peak height, area under curve, time peak, velocity. This explained, respectively, levels 47, 59, 25 53%; count 45, 28, 44, 14%; combination 80, 67, 70, 62% variance; additional interaction 91, 84, 76, 68%. at 40 × 109/L an approximate 25% concentration similar 150 × 109/L. Similarly, patient ex vivo also highly significant improvements TG. Conclusions improved PCCs, supporting need for studies coagulopathies characterized mild moderate abnormal coagulation.