The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report | [Anaesthesia, Pain and Intensive Care • 2024]

Author(s):

1. Aditia Pria Laksana: Department of Anesthesiology and Intensive Therapy, University of Indonesia, Cipto Mangunkusumo Hospital,Jakarta,Indonesia

2. Sidharta Kusuma Manggala: Department of Anesthesiology and Intensive Therapy, University of Indonesia, Cipto Mangunkusumo Hospital,Jakarta,Indonesia

3. Vera Irawany: Department of Anesthesiology and Intensive Therapy, Fatmawati Hospital,Jakarta,Indonesia

Abstract:

Blunt abdominal trauma is an event that can cause massive internal bleeding and can be life-threatening. Splenectomy is often performed to treat organ injuries in patients with blunt abdominal trauma. However, splenectomy can cause hemostasis problems, which can cause more bleeding and risk complications such as Acute Kidney Injury (AKI). This case report aims to discuss the role of prothrombin complex concentrate (PCC) in treating bleeding and preventing AKI in blunt abdominal trauma patients after splenectomy at Fatmawati Hospital, Jakarta, Indonesia. A 15-year-old woman experienced blunt abdominal trauma due to a sports accident and sustained internal bleeding. After a thorough evaluation, she underwent an emergency splenectomy to stop the bleeding. However, patients developed hemostasis problem which made the control of postoperative bleeding difficult. To overcome this problem, patient was administered PCC intravenously, which resulted in significant improvement in controlling postoperative bleeding. The hematocrit level and red blood cell count steadily increased, indicating the effectiveness of PCC in improving the patient's hemostasis. PCC can play an important role in treating post-splenectomy bleeding in patients with blunt abdominal trauma. Apart from that, the use of PCC can also help prevent AKI, which is a serious and life-threatening complication. Further research and clinical trials are needed to confirm the benefits of using PCC in a broader patient population with similar conditions.

Page(s): 177-181

DOI: 10.35975/apic.v28i1.2289

Published: Journal: Anaesthesia, Pain and Intensive Care, Volume: 28, Issue: 1, Year: 2024

Keywords:

Acute Kidney Injury , Blunt abdominal trauma , bleeding , Splenectomy , Prothrombin Complex Concentrate

References:

[1] Bhatt HV,Subramaniam K. .2017 .PRO: Prothrombin Complex Concentrate Should Be Used in Preference to Fresh Frozen Plasma for Hemostasis in Cardiac Surgical Patients. J Cardiothorac Vasc Anesth, 05(2) : 1062-1067.

[2] Dickneite G,Pragst I.,Dehours E,Samama CM,Jhundoo S,Pujeau F,Guillaudin C,Levy JH .2012 .Prothrombin complex concentrates in trauma and perioperative bleeding. Anesthesiology., 16(5) : R185-54.

[3] Han SS,Baek SH,Ahn SY,Chin HJ,Na KY,Chae DW,Kim S. .2015 .. , 122(4) : 923-31.

[4] CM Samama,S0265021508004675 Sayce AC,Neal MD,Leeper CM .2020 .Viscoelastic monitoring in trauma resuscitation. Transfusion, 60(Suppl 6) : S33-S51.

[5] Spahn DR,Bouillon B,Cerny V,Duranteau J,Filipescu D,Hunt BJ,Yasaka M,Sakata T,Naritomi H,Minematsu K.,Zemrak W,Manuel F,Smith KE,Rolfe S,Hayes T,Trowbridge RL .2019 .Low-dose compared to manufacturer-recommended dose four-factor prothrombin complex concentrate for acute warfarin reversal. Thromb Thrombolysis, 47(2) : 263-271.

[6] . .. [PubMed] DOI: 10.1007/s11239-018-1768-1, : .

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