Prothrombin Complex Concentrate: Anticoagulation Reversal and Beyond

  • O. GrottkeEmail author
  • H. Schöchl
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


Prothrombin complex concentrates (PCCs) are plasma‐derived coagulation factor concentrates. All PCCs contain factors II, IX and X, and four‐factor PCCs also contain factor VII. Most PCCs contain coagulation factors that are not activated, but activated PCC contains activated factor VII (FVII). The ratio of quantities of coagulation factor concentrations varies from one PCC to another [1]. Further differences between PCCs relate to constituents other than coagulation factors: they contain different amounts of inhibitors, such as heparin, antithrombin and proteins C, S and Z. Despite this variability, however, levels of inhibitors are always much lower than those of the coagulation factors.

PCCs are mainly used for emergency reversal of the effects of vitamin K antagonists (VKAs). Circumstances demanding rapid anticoagulation reversal include unplanned, urgent surgery and trauma‐related bleeding. VKAs, such as warfarin, function by preventing synthesis of the...


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Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of AnesthesiologyRWTH Aachen University HospitalAachenGermany
  2. 2.Ludwig Boltzmann Institute for Experimental and Clinical TraumatologyAUVA Research CentreViennaAustria
  3. 3.Department of Anaesthesiology and Intensive CareAUVA Trauma CentreSalzburgAustria

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