Abstract Number: PB1314
Meeting: ISTH 2021 Congress
Background: Effective treatment of massive obstetric haemorrhage is important; however, the optimal therapy is still not known.
Aims: We aimed to compare the efficacy of first-line therapy using cryoprecipitate (CP) or prothrombin complex concentrate (PCC) for the reversal of induced coagulopathy, and consequently the development of multiple organ dysfunction syndrome (MODS).
Methods: Having agreed with the local Ethics Committee and obtained the informed consents, 75 women (whose delivery or early postpartum period was complicated by severe hemorrhage with blood volume (BV) deficit of 40-52%) were examined. Patients were randomized into 2 groups depending on the characteristics of the BV replenishment. Both groups were similar in relation to age, height, gestation term, blood loss volume (2570±510 ml). In 1 group (n=42) of first-line prevention of progression severe coagulopathy using CP (5-8 U). In group 2 (n = 33), the first-line drug was used for 1500 IU (20 mg / kg) PCC. Clinical signs of MODS are accounted for myocardial insufficiency (frequency and duration of vasopressor support); respiratory dysfunction (frequency and duration of mechanical ventilation); acute kidney injury (frequency and duration of use of diuretics), gastrointestinal dysfunction (frequency and duration of the enteroparesis).
Results: Analysis showed that use of PCC reduced total infusion-transfusion volume by 24.5% (1300 ml). Patients 2 group had decreased frequency and duration of VS, frequency and duration of MV, had reduced the number of patients requiring RRT, and it duration. The frequency GIT dysfunction reduced more than twice. This provided a significant reduction in the duration of stay in the ICU from 10.7±1.5 (1 group) to 7.8±2.1 days (2 group).
Conclusions: Our results underline the importance of early and effective factor concentrates supplementation for severe coagulopathy in massive obstetric haemorrhage. The available sample size in our study appears sufficient to make some conclusions that first-line PCC is superior to CP.
To cite this abstract in AMA style:Sedinkin V, Klygunenko O, Volkov O. The Effect of Prothrombin Complex Concentrate and Cryoprecipitate on the Frequency and Severity of Multiple Organ Dysfunction Syndrome in Massive Obstetric Haemorrhage [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/the-effect-of-prothrombin-complex-concentrate-and-cryoprecipitate-on-the-frequency-and-severity-of-multiple-organ-dysfunction-syndrome-in-massive-obstetric-haemorrhage/. Accessed January 28, 2022.
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