Activated Prothrombin Complex Concentrate for coagulopathy reversal secondary to ischemic hepatic injury due to cardiac tamponade: A case report
| Autor: | Hassan Mitwally, Dore C. Ananthegowda, Amr Mohamed Fahmi, Alaa Rahhal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Prothrombin Complex Concentrate medicine.medical_treatment Case Report 03 medical and health sciences Liver disease 0302 clinical medicine Coagulopathy Internal medicine Cardiac tamponade medicine Liver injury business.industry fungi food and beverages Pericardiocentesis medicine.disease Prothrombin complex concentrate 030220 oncology & carcinogenesis Cardiology 030211 gastroenterology & hepatology Surgery Tamponade Heart failure with preserved ejection fraction business medicine.drug |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • Pericardiocentesis is an emergency procedure in patients with pericardial effusion and evidence of tamponade. • Decrease in cardiac output secondary to tamponade can lead to ischemic hepatitis and coagulopathy. • Coagulopathy reversal is important prior to pericardiocentesis. • Activated Prothrombin complex concentrate can be an option in fast reversal of coagulopathy prior to pericardiocentesis. Introduction and importance Correction of coagulopathy is needed before invasive procedures. However, there is limited evidence to support using Prothrombin Complex Concentrate (PCC) to reverse coagulopathy secondary to liver disease. Case presentation We report a case of a 68-year-old male patient a known case of heart failure with preserved ejection fraction, who developed cardiac tamponade, resulting in hemodynamic instability and ischemic liver injury leading to coagulopathy of INR 2.3. Activated PCC (FEIBA) was used to reverse coagulopathy. INR dropped to 1.9 and the procedure was performed uneventfully with successful elimination of tamponade signs evidenced by echocardiography. Clinical discussion In this case, the patient required an urgent pericardiocentesis. Activated PCC used successfully to reverse coagulopathy, which was important prior to the procedure. Conclusion In view of the need for urgent pericardiocentesis, coagulopathy due to ischemic liver injury could be reversed with the use of activated PCC. |
| Databáze: | OpenAIRE |
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