Cardiothoracic & vascular anesthesia
Dose-dependent Effects of Four-factor Prothrombin Complex Concentrate on Clotting Time in Rotational Thromboelastometry—A Retrospective Cohort Study
Authors' conclusion
Weight-based PCC dosing yields inconsistent reductions in ROTEM-measured CT after cardiac surgery. EXTEM-CT is an unreliable predictor of severe postoperative bleeding
Study context
- Population
- Adults undergoing cardiac or aortic surgery (May 2022–August 2024) who received a single prothrombin complex concentrate (PCC) dose between two rotational thromboelastometry (ROTEM) assessments, high-volume tertiary academic cardiac centre
- Participants
- 175 adults
- Exposure
- Dose of a single four-factor PCC dose and change in EXTEM-CT
- PCCn = 175
- Outcome
- Change in EXTEM-CT (ΔCT) between pre- and post-PCC ROTEM measurements
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
ΔCT (robust linear regression adjusted for on-pump EXTEM-CT)
Median EXTEM-CT pre-PCC (seconds)
104
Median EXTEM-CT post-PCC (seconds)
76
On-pump EXTEM-CT, strongest predictor of ΔCT (β; p < 0.001)
−0.91
Adjusted effect of PCC dose on ΔCT, modest and not significant (β; p = 0.14)
0.11
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| Discrimination of post-PCC EXTEM-CT for severe postoperative bleedingPoor discrimination | PCC AUC 0.486 |
Original publication
Dose-dependent Effects of Four-factor Prothrombin Complex Concentrate on Clotting Time in Rotational Thromboelastometry—A Retrospective Cohort Study. J Cardiothorac Vasc Anesth. Published 3 April 2026. doi:10.
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