Prothrombin complex concentrate in trauma patients

Background: Despite recent advances, trauma care providers nowadays face a number of coagulopathic patients. Coagulopathy in trauma patients can be secondary to the traumatic insult or therapeutic effect of the anticoagulants including the Vitamin K antagonist. The efficacy of a concentrated product of Vitamin K-dependent coagulation factors, prothrombin complex concentrate (PCC), to reverse coagulopathy has been tested mainly in nontrauma setting.

Data sources: Currently available literature on the use of PCC was identified by searches of electronic database. The indications (trauma vs nontrauma) and types of the PCC products (3 vs 4 factors) were also reviewed in each article.

Conclusions: There are small studies that show promising results regarding PCC use to reverse the Vitamin K antagonist-related coagulopathy in trauma patients. It remains unanswered whether PCC can be effective as an adjunct in patients who require massive transfusion.