Fatma KEREN, Eda ŞİMŞEK TANRIKULU, Özlem BALÇIK ŞAHİN, Ali KOŞAR

Warfarine bağlı antikoagulan etkiyi geri çevirmede protrombin kompleks konsantresi kullanımı: Tek merkez deneyimi

Amaç : Antikoagülan etkinin düzeltilmesi amacıyla kullanılan protrombin kompleks konsantresi (PCC) etkin ve güvenilir bir tedavi alternatifidir. Bu nedenle kliniğimizde varfarine bağlı antikoagülan etkiyi normale getirmek amacıyla kullanılan PCC ve taze donmuş plazma (TDP) arasındaki farkı ve benzerlikleri değerlendirdik. Materyal ve Metot: Kliniğimizde varfarin doz aşımına bağlı kanaması olan ve varfarin kullanıp acil cerrahi operasyon planlanan INR değerleri yüksek olan 50 hasta değerlendirildi. INR değerlerini normalize etmek için 25 hastaya PCC, 25 hastaya TDP kullanıldı, verileri retrospektif olarak değerlendirildi. Bulgular: PCC grubunda ve TDP grubunda endikasyon yönünden fark yoktu ve PCC grubunun yaş ortalaması daha yüksekti (p:0,021). PCC grubunda TDP grubuna göre tedavi öncesi protrombin zamanı (PT) (p:0,001), INR değeri (p:0,001) daha yüksekti. Tedavi sonrası PCC grubunda PT değeri (p:0,001) ve INR değeri (p:0,001) daha fazla düşmüştü. Sonuçlar: Bu bulgular bize antikoagülan tedavinin hızla geri döndürülmesi gerektiği durumlarda PCC tedavisinin etkin ve güvenli bir seçenek olduğunu göstermektedir. Özellikle yaşlı hastalarda da güvenle kullanılabilen alternatif bir tedavi seçeneği olabilir.

To use prothrombin complex concentrate for reversing the anticoagulant effect depending on warfarin: A single-center study

Background: PCC is a safe and effective alternative treatment that is used for the purpose of revising the anticoagulant effect. Therefore, in our clinic we evaluated the differences and similarities between PCC and fresh frozen plazma (FFP) which are used to normalize anticoagulant effect of warfarin. Materials and Methods : In our clinic 50 patients were evaluated with high INR values, who had on bleeding due to warfarin overdose and who were planned to have emergency surgical operations using warfarin. To normalize INR values 25 patients were used PCC and 25 patients were used FFP, data were retrospectively evaluated. Results : PCC group and FFP groups did not differ in terms of indications and PCC group had a higher mean age (p=0.021). In PCC group pre-treatment prothrombin time (PT) (p= 0.001) and INR values (p= 0.001) were higher than FFP group. After treatment PT value (p= 0.001) and INR values (p=0.001) decreased more in the PCC group. Conclusions : These results shows us the PCC is an effective and reliable treatment in cases were the anticoagulant therapy has to be reversed quickly. It is an alternative treatment which can especially be used in elderly patients too.

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