Efficacy and Safety of Prothrombin complex Concentrate in Patients with Massive Intraoperative Bleeding During non-Cardiac Surgery: A Retrospective Cohort Study.

Among patients with a preoperative fibrinogen level ≥3 g/l, 4F-PCC administration (at a dose of 11.5–19.4 IU/kg) was significantly associated with a lower volume of postoperative RBC transfusion compared to those who did not receive 4F-PCC (MD −2.10 units; 95%CI −3.93 to −0.27 units, P = 0.025); further, patients who received 4F-PCC at a dose of 6.7–11.5 IU/kg showed a nonsignificant trend toward requiring a lower volume of postoperative RBC transfusion when compared to those without 4F-PCC administration (MD −1.54 units; 95%CI −3.16 to 0.08 units, P = 0.062) (adjusted for age, sex, surgery type, volume of intraoperative RBC transfusion, fluid infusion, and volume of perioperative plasma, platelets, and fibrinogen concentrate transfusion).

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And patients who received 4F-PCC at a dose of 11.5–19.4 IU/kg showed a non-significant trend toward requiring a lower volume of postoperative RBC transfusion when compared to those without 4F-PCC administration (MD −1.18 units; 95%CI −2.58 to 0.21 units, P = 0.096), though this did not reach statistical significance.

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