{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T11:21:19Z","timestamp":1772191279801,"version":"3.50.1"},"reference-count":32,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Semin Thromb Hemost"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pediatric cardiac surgery patients are predisposed to blood loss. Blood product administration can lead to complications. Prothrombin complex concentrates (PCCs) offer potential advantages of factor composition, small volume, decreased immunogenicity\/infectious risks, and accessibility. The objective of this study was to describe dosing, monitoring, blood product utilization, and thromboembolic complications of administering four-factor PCC (4F-PCC) in pediatric cardiac surgery. We performed a retrospective review of patients aged &lt;18 years undergoing cardiac surgery from June 2020 to May 2022 (inclusive) who received 4F-PCC. Outcomes of interest included 4F-PCC dosing (units\/kg) and number of doses administered, chest tube output, blood product administration, donor exposure, length of stay, and thromboembolic events. Eighty-six patients met eligibility criteria. The median (range) age and weight were 0.37 (0.01\u201316.3) years and 5.3 (1.6\u201398) kg, respectively. Median (range) total 4F-PCC dose per patient was 25 (9.2\u201350) units\/kg, with 6 patients (7%) receiving a total of two doses. Median (range) 24-hour postoperative packed red blood cells, platelet, plasma, and cryoprecipitate administration volumes were 0 (0\u20132.57) mL\/kg\/24\u2009h, 0 (0\u20131.09), 0 (0\u20132.64), and 0 (0\u20130.28\u2009mL\/kg\/24\u2009h), respectively. Median (range) length of stay and 24-hour postoperative chest tube output were 10 (6\u201326) days and 1.1 (0.1\u20134.2) mL\/kg\/h, respectively. Two (2%) patients experienced a thromboembolic event within 30 days of 4F-PCC administration. These retrospective findings suggest no worsening of hemostatic parameters, a mild median improvement in fibrinogen, low blood product utilization, and low thromboembolism rates following 4F-PCC use in pediatric cardiac surgery.<\/jats:p>","DOI":"10.1055\/s-0043-1777301","type":"journal-article","created":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T00:28:55Z","timestamp":1701736135000},"page":"873-882","source":"Crossref","is-referenced-by-count":2,"title":["Dosing, Monitoring, Blood Product Utilization, and Thromboembolic Complications of Four-Factor Prothrombin Complex Concentrate as Part of an Institutional Protocol in Pediatric Cardiac Surgery: A Retrospective Cohort Study"],"prefix":"10.1055","volume":"50","author":[{"given":"Amy L.","family":"Kiskaddon","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"},{"name":"Division of Cardiology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"},{"name":"Heart Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil A.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"},{"name":"Division of Hematology, Departments of Medicine and Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland"},{"name":"Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie L.","family":"Fierstein","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Shared Resource, Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Miller","sequence":"additional","affiliation":[{"name":"Epidemiology and Biostatistics Shared Resource, Institute for Clinical and Translational Research, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James A.","family":"Quintessenza","sequence":"additional","affiliation":[{"name":"Heart Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vyas M.","family":"Kartha","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida"},{"name":"Division of Anesthesiology and Critical Care Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, 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