Conclusion
The review concludes that the institution’s operatively timed weight
based PCC4 dosing protocol is medically feasible, safe, and may further
reduce post-operative bleeding and the associated complications of
significant blood product transfusion. Intraoperative PCC4 was well
tolerated. There was a trend towards an overall therapeutic benefit with
a slowed rate of postoperative chest tube output (approximately
32ml/hr). We observed no increase in adverse events. An adequately
powered randomized controlled trial comparing the observed
intraoperative dose and timing of PCC4 versus traditional interventional
bleeding management with blood product transfusion following high risk
cardiothoracic surgery is recommended.