Journal Club: Prothrombin complex concentrates (PCCs) in trauma patients, review of trauma-induced coagulopathy and rationale for PCCs and discussion of the PROCOAG study

Presented by

Dr. Charles Lafrance
Transfusion Medicine Physician Trainee
University of Toronto, Toronto

Learning objectives

1. Understand the pathogenesis of trauma-induced coagulopathy
2. Review the available literature about PCC indications and use in trauma and other settings
3. Discuss the results of the PROCOAG study and their application in trauma care

References

1. Bouzat P, Charbit J, Abback P, et al. Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial. JAMA. 2023;329(16):1367–1375. doi:10.1001/jama.2023.4080.
2. Moore, H.B., Gando, S., Iba, T., Kim, P.Y., Yeh, C.H., Brohi, K., Hunt, B.J., Levy, J.H., Draxler, D.F., Stanworth, S., Görlinger, K., Neal, M.D., Schreiber, M.A., Barrett, C.D., Medcalf, R.L., Moore, E.E., Mutch, N.J., Thachil, J., Urano, T., Thomas, S., Scărlătescu, E., Walsh, M. and (2020), Defining trauma-induced coagulopathy with respect to future implications for patient management: Communication from the SSC of the ISTH. J Thromb Haemost, 18: 740-747. https://doi.org/10.1111/jth.14690
3. Schöchl, H., Nienaber, U., Hofer, G. et al. Goal-directed coagulation management of major trauma patients using thromboelastometry (ROTEM^®)-guided administration of fibrinogen concentrate and prothrombin complex concentrate. Crit Care 14, R55 (2010).
4. Schöchl, H., Nienaber, U., Maegele, M. et al. Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy. Crit Care 15, R83 (2011).
5. Four-factor prothrombin complex concentrate is associated with improved survival in trauma-related hemorrhage: A nationwide propensity-matched analysis.. Muhammad M Zeeshan et al. Journal of Trauma and Acute Care Surgery 87(2). 2019.

Note: The session is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada.

Registration

Closed

Appraisal

Closed

To be added to the distribution list for the LearnTransfusion series, send an email to learn.transfusion@blood.ca  with “Weekly Transfusion Medicine Seminars” in the subject line. Include your name and complete e-mail address in the body of the e-mail and confirm that you would like to be added to the distribution list for the LearnTransfusion series. You will then receive weekly email notifications of upcoming series events with details on how to join the webinars (e.g.,  link to register for the webinar).

The LearnTransfusion series is the seminar component of the Areas of Focused Competency (AFC)-Diploma Program in Transfusion Medicine. The series, organized by Canadian Blood Services, is also open to all practitioners in the field of Transfusion Medicine. Through a series of regular webinars, trainees and practitioners are exposed to various scientific, technical and clinical aspects of transfusion medicine.