Theoretical Modeling of Coagulation Management With Therapeutic Plasma or Prothrombin Complex Concentrate

Anesth Analg. 2017 Nov;125(5):1471-1474. doi: 10.1213/ANE.0000000000002410.

Abstract

Prothrombin complex concentrates (PCCs) have been associated with a possible risk of thromboembolic complications, potentially attributable to an increased ratio of the plasma concentration of factor II (FII) to antithrombin (AT). We developed a mathematical model to examine the relationship between amounts of PCC or therapeutic plasma administered, and plasma levels of FII and AT. The model showed that PCC produces substantial increases in plasma levels of FII but only small changes in AT, increasing the FII:AT ratio. Therapeutic plasma was shown to have only modest effects on levels of FII or AT, unless high doses are used.

MeSH terms

  • Antithrombins / metabolism
  • Blood Coagulation / drug effects*
  • Blood Coagulation Factors / adverse effects
  • Blood Coagulation Factors / therapeutic use*
  • Crystalloid Solutions
  • Hemorrhage / blood
  • Hemorrhage / prevention & control*
  • Hemostatics / adverse effects
  • Hemostatics / therapeutic use*
  • Humans
  • Isotonic Solutions / therapeutic use
  • Models, Biological*
  • Plasma Substitutes / therapeutic use
  • Plasma Volume
  • Prothrombin / metabolism

Substances

  • Antithrombins
  • Blood Coagulation Factors
  • Crystalloid Solutions
  • Hemostatics
  • Isotonic Solutions
  • Plasma Substitutes
  • prothrombin complex concentrates
  • Prothrombin