{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:46:38Z","timestamp":1781199998926,"version":"3.54.1"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,12,26]],"date-time":"2018-12-26T00:00:00Z","timestamp":1545782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Idarucizumab (IDA) is approved for emergency reversal of dabigatran; prothrombin complex concentrates (PCCs) are recommended in the absence of specific antidote. The combined effects of IDA and PCC in trauma\u2010related bleeding are unknown. The efficacy and safety of combined IDA + PCC were assessed in a lethal porcine model of double trauma under dabigatran anticoagulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>Male pigs (n = 28) received oral dabigatran etexilate (30 mg\/kg bid) for 3 days; a non\u2010dabigatran control group (n = 7) received placebo. On Day 4, dabigatran\u2010treated animals were randomized 1:1:1:1 to receive placebo + placebo (dabigatran\u2010treated control), IDA + PCC (60 mg\/kg + 50 IU\/kg), PCC + IDA, or IDA + IDA. Trauma was induced at t = 0 (bilateral femur fractures and blunt liver injury) and t = 60 minutes (second blunt liver injury). Study treatment was administered 15 minutes after each trauma. Animals were monitored for 5 hours or until death.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Total blood loss in IDA + PCC, PCC + IDA, and IDA + IDA was 1673 \u00b1 370, 1981 \u00b1 361, and 1417 \u00b1 135 mL, respectively, with 100% survival at 5 hours. Blood loss in dabigatran\u2010treated controls was 4427 \u00b1 162 mL with 100% mortality. With IDA + IDA, plasma coagulation parameters and thrombin generation were similar to non\u2010dabigatran control group levels after the second dose and remained stable over time. In the IDA + PCC and PCC + IDA groups, thrombin generation and <jats:sc>d<\/jats:sc>\u2010dimer levels after the second dose were higher than with IDA + IDA. No thromboembolic complications were found.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>IDA and PCC are effective in treating trauma\u2010related bleeding with dabigatran anticoagulation. IDA is preferable for emergency reversal of dabigatran, but PCC may be valuable when the anticoagulant is unknown.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15117","type":"journal-article","created":{"date-parts":[[2018,12,26]],"date-time":"2018-12-26T19:53:32Z","timestamp":1545854012000},"page":"1376-1387","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of combined idarucizumab and prothrombin complex concentrate treatment for bleeding related to dabigatran in a lethal porcine model of double trauma"],"prefix":"10.1111","volume":"59","author":[{"given":"Markus","family":"Honickel","sequence":"first","affiliation":[{"name":"Department of Anesthesiology RWTH Aachen University Hospital  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"Braunschweig","sequence":"additional","affiliation":[{"name":"Department of Pathology RWTH Aachen University Hospital  Aachen 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