Prothrombin Complex Concentrates: Advances in Research and Clinical Applications

Michael S. Firstenberg, M.D. (Editor)
Department of Surgery (Cardiothoracic), The Medical Center of Aurora, Aurora, Colorado, US

Series: Recent Advances in Hematology Research
BISAC: MED038000

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Volume 10

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Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick

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As the population ages and elderly co-morbidity becomes more complex, innovative therapies have been developed to assist in the management of these medical problems. While such therapies have been shown to improve the quantity and quality of life, they often will come with inherent risks/complications – complications that can be potentially life threatening. Two such categories of therapies are anti-coagulants and anti-platelet agents. However, such therapies are associated with a significant increased risk for bleeding and bleeding related complications. These complications, while occasionally spontaneous, can also present the need for invasive procedures, like surgery. Unfortunately, the parallel development of effective reversal agents or antidotes for these therapies has not kept pace.

As such, there are growing concerns that traditional therapies for the treatment of bleeding – regardless of the etiology and magnitude – are less than ideal. Agents for the management of bleeding, such as blood products, single agent recombinant factors, and bio-surgical agents (glues, pastes, sprays, and cellulose based materials) all have a role. However, each has limitations with regards to effectiveness, cost, and risk. Unfortunately, while there are some therapies that specifically target defects in the clotting cascades, rarely is a single agent sufficient enough to solve the clinical problem at hand.

Prothrombin complex concentrates represent a novel class of compounds that are evolving into a critical tool for the management of bleeding and bleeding related complications. There are a variety of compounds clinically available, and these agents consist of key clotting factors that have a role in achieving rapid hemostasis. Even though such compounds might just represent an additional tool in a growing armamentarium of hemostasis products, their clinical roles and effectiveness are still being defined.

The goal of this book is to illustrate the spectrum of applications for prothrombin complex concentrates. The chapters trace the development of these agents, their mechanisms of action, the potential clinical applications, and highlight the key literature concerning their use. (Imprint: Nova Biomedical)

Preface

Chapter 1. Prothrombin Complex Concentrates: History, Production, Techniques and Component Properties
Maureen E. Cheung, Logan T. Mellert and Eric A. Espinal (Department of Surgery, Western Reserve Hospital, Cuyahoga Fall, OH, USA, and others)

Chapter 2. The Origins of Prothrombin Complex Concentrates
Nolan Mann, Michael Subichin and Jesse Clanton (Department of Surgery, Summa Health System, Akron City Hospital, Akron, OH, USA, and others)

Chapter 3. Prothrombin Complex Concentrates for Reversal of Oral Anticoagulant-Associated Bleeding
J. Michael Boyd and Nicholas Boniface (Department of Pharmacy, The Ohio State University Wexner Medical Center, Columbus, OH, USA, and others)

Chapter 4. Off Label Use of Four Factor Prothrombin Complex Concentrate: Drug-Induced Coagulopathies, Disease-Induced Coagulopathies, and Attenutated Dosing
Stephanie Bennett, Elizabeth Greenhalgh and Megan Rech (Loyola University Medical Center Department of Pharmacy, Maywood, IL, USA, and others)

Chapter 5. Perioperative Usage of Prothrombin Complex Concentrates
Craig Kornbau and Michael Firstenberg (Department of Surgery (Cardiothoracic), Summa Health System, Akron, OH, and others)

Chapter 6. Prothrombin Complex Concentrates for Abdominal Trauma
Heidi R. Kemmer, Jason Hecht, Michael J. Brozik, and Harry L. Anderson III (St. Joseph Mercy Ann Arbor, Ann Arbor, MI, USA)

Chapter 7. Coagulopathy and the Trauma Patient
Seye Adekeye, Mentor Ahmeti and Cornelius Dyke (Department of Surgery, University of North Dakota School of Medicine and Health Sciences, ND, USA)

Chapter 8. Prothrombin Complex Concentrates in Pregnancy and the Puerperium
Jacquelyn H. Adams, Michele L. Mccarroll and Angela Silber (Department of Obstetrics and Gynecology, Summa Health System, Akron, OH, USA)

Chapter 9. Prothrombin Complex Concentrates: Clinical Applications in Heart Transplants and Mechanical Circulatory Support
Matthew R. Wanek, J. Brad Williams, Marijan Koprivanac, and Nader Moazami (Cleveland Clinic, Cleveland, Ohio, OH, USA)

Chapter 10. Prothrombin Complex Concentrates in Anticoagulant-Associated Intracranial Hemorrhage
Philip K. King, John V. Barrord, Susana M Bowling, and Joao A. Gomes (Department of Pharmacy, Summa Health, Akron City Hospital, Akron, OH, USA, and others)

Index

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