The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report

Anaesthesia, Pain & Intensive Care Pub Date : 2024-05-02 DOI:10.35975/apic.v28i1.2289

Aditia Pria Laksana, S. Manggala, Vera Irawany

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Abstract

Blunt abdominal trauma is an event that can cause massive internal bleeding and can be life-threatening. Splenectomy is often performed to treat organ injuries in patients with blunt abdominal trauma. However, splenectomy can cause hemostasis problems, which can cause more bleeding and risk complications such as Acute Kidney Injury (AKI). This case report aims to discuss the role of prothrombin complex concentrate (PCC) in treating bleeding and preventing AKI in blunt abdominal trauma patients after splenectomy at Fatmawati Hospital, Jakarta, Indonesia. A 15-year-old woman experienced blunt abdominal trauma due to a sports accident and sustained internal bleeding. After a thorough evaluation, she underwent an emergency splenectomy to stop the bleeding. However, patients developed hemostasis problem which made the control of postoperative bleeding difficult. To overcome this problem, patient was administered PCC intravenously, which resulted in significant improvement in controlling postoperative bleeding. The hematocrit level and red blood cell count steadily increased, indicating the effectiveness of PCC in improving the patient's hemostasis. PCC can play an important role in treating post-splenectomy bleeding in patients with blunt abdominal trauma. Apart from that, the use of PCC can also help prevent AKI, which is a serious and life-threatening complication. Further research and clinical trials are needed to confirm the benefits of using PCC in a broader patient population with similar conditions. Abbreviations: AKI- Acute Kidney Injury; PCC- Prothrombin Complex Concentrate Keywords: Acute Kidney Injury; Bleeding; Blunt Abdominal Trauma; Prothrombin Complex Concentrate; Splenectomy Citation: Laksana AP, Manggala SK, Irawany V. The role of prothrombin complex concentrate to control critical bleeding after splenectomy for blunt abdominal trauma; A case report. Anaesth. pain intensive care 2024;28(1):177−181; DOI: 10.35975/apic.v28i1.2289 Received: September 13, 2023; Reviewed: October 29, 2023; Accepted: December 19, 2023

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腹部钝挫伤脾脏切除术后凝血酶原复合物浓缩物在控制严重出血中的作用；病例报告

腹部钝性外伤可导致大量内出血，危及生命。脾切除术通常用于治疗腹部钝挫伤患者的器官损伤。然而，脾切除术可能会引起止血问题，从而导致更多出血，并有可能引发急性肾损伤（AKI）等并发症。本病例报告旨在讨论凝血酶原复合物浓缩物（PCC）在印度尼西亚雅加达法特玛瓦蒂医院腹部钝伤患者脾脏切除术后治疗出血和预防急性肾损伤中的作用。一名 15 岁的女性因运动意外造成腹部钝挫伤，导致内出血。经过全面评估后，她接受了紧急脾脏切除术以止血。然而，患者出现止血问题，导致术后出血难以控制。为了解决这个问题，患者接受了 PCC 静脉注射，结果在控制术后出血方面有了明显改善。患者的血细胞比容水平和红细胞计数稳步上升，这表明 PCC 在改善患者止血方面效果显著。PCC 可在治疗腹部钝挫伤患者脾切除术后出血方面发挥重要作用。此外，使用 PCC 还有助于预防 AKI，这是一种严重且危及生命的并发症。还需要进一步的研究和临床试验来证实在更多类似情况的患者中使用 PCC 的益处。缩写：缩写：AKI- 急性肾损伤；PCC- 凝血酶原复合物浓缩物关键词：急性肾损伤；PCC；凝血酶原复合物浓缩物急性肾损伤；出血；腹部钝性创伤；凝血酶原复合物浓缩物；脾脏切除术引文： Laksana AP、Manggala Manggala、Laksana AP、Manggala Manggala、Laksana APLaksana AP, Manggala SK, Irawany V. 腹部钝挫伤脾切除术后凝血酶原复合物浓缩物对控制严重出血的作用；病例报告。Anaesth. pain intensive care 2024; 28(1):177-181; DOI: 10.35975/apic.v28i1.2289 Received：收稿日期：2023 年 9 月 13 日；审稿日期：2023 年 10 月 29 日；接受日期：2023 年 10 月 29 日：收稿日期：2023 年 9 月 13 日；审稿日期：2023 年 10 月 29 日；接受日期：2023 年 12 月 19 日：接受：2023 年 12 月 19 日

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Anaesthesia, Pain & Intensive Care

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