{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T17:49:49Z","timestamp":1792259389892,"version":"4.4.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"abstract":"<jats:p>\n                    Four-factor prothrombin concentrate complex (4F-PCC) may be used for significant bleeding following cardiac surgery but the optimal dosing has not been established. The purpose of this study was to compare two dosing strategies of 4F-PCC in cardiac surgery patients. This retrospective chart review evaluated 4F-PCC dosing of 25\u00a0units\/kg compared to 12.5\u00a0units\/kg in cardiac surgery patients following a protocol change for 4F-PCC dosing. The primary outcome was major bleeding, defined as the number of patients receiving \u22653 packed red blood cell (PRBC) transfusions within 24\u00a0h of 4F-PCC administration. Secondary outcomes included other surrogate markers for bleeding (eg, Use of other blood products and hemostatic agents), thrombotic events within 14\u00a0days of surgery, hospital length of stay, and all-cause mortality. A total of 42 patients were included (31 patients in the 25\u00a0units\/kg group and 11 patients in the 12.5\u00a0units\/kg group). There was no difference in the number of patients that received \u22653 PRBC transfusions between the two groups with 15 patients (47.4%) in 25\u00a0units\/kg group and 3 patients (27.3%) in 12.5\u00a0units\/kg (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .299). Additionally, no difference was observed in amount of additional hemostatic agents administered, hospital length of stay or mortality between the two groups. A higher rate of thromboembolic events was observed among patients receiving 25\u00a0units\/kg vs 12.5\u00a0units\/kg (22.6% vs 0%,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    = .161). Reduced dosing of 4F-PCC from 25\u00a0units\/kg to 12.5\u00a0units\/kg following cardiac surgery resulted in no difference in clinical or effectiveness outcomes.\n                  <\/jats:p>","DOI":"10.1177\/08971900261497555","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:38:11Z","timestamp":1792107491000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Four-Factor Prothrombin Complex Concentrate Dosing for Major Bleeding Following Cardiac Surgery"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4946-7088","authenticated-orcid":false,"given":"Bethany T.","family":"Mullinax","sequence":"first","affiliation":[{"name":"Pharmacy Department, Grady Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn","family":"Pinkos","sequence":"additional","affiliation":[{"name":"Pharmacy Department, NewYork-Presbyterian Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul","family":"Dilawri","sequence":"additional","affiliation":[{"name":"Pharmacy Department, NewYork-Presbyterian Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3514-1279","authenticated-orcid":false,"given":"Melissa","family":"Santiba\u00f1ez","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Nova Southeastern University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Salerno","sequence":"additional","affiliation":[{"name":"Pharmacy Department, NewYork-Presbyterian Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-3468","authenticated-orcid":false,"given":"Karen","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, Nova Southeastern University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-019-0881-3"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1060028017752365"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezx325"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/cc9311"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001188"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1160\/TH16-02-0094"},{"key":"e_1_3_4_8_2","volume-title":"KCENTRA (Prothrombin Complex Concentrate (Human))","year":"2013","unstructured":"KCENTRA (Prothrombin Complex Concentrate (Human)). Marburg, Germany: CSL Behring GmbH; 2013. 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