PCC vs. FFP for Post Cardiopulmonary Bypass Coagulopathy and Bleeding

Inclusion Criteria

All subjects accepted for this study must:

- Be 18 years of age

- Be undergoing elective cardiac surgical procedure utilizing cardiopulmonary bypass

- Have evidence of excessive microvascular bleeding in the surgical field as determined
by the surgical team in addition to a PT >16.6 sec or INR >1.6 sec.

Exclusion Criteria

Subjects who have one or more of the following will be excluded from the study:

- Are unable to grant informed consent or comply with study procedure

- History of hypercoagulable condition (e.g. Factor V Leiden, AT-3 deficiency,
Prothrombin gene mutation, Anti-phospholipid antibody syndrome, etc) or previous
unprovoked thromboembolic complications

- Coagulopathic conditions such as factor deficiencies, factor inhibitors, heparin
induced thrombocytopenia, or use of intravenous anticoagulants other than heparin at
the time of cardiovascular surgery

- Thromboembolic event within past 3 months

- Received oral therapy with clopidogrel, prasugrel, rivaroxaban or dabigatran within
the past 5 days

- Patients taking chronic warfarin therapy who have not discontinued treatment and
demonstrated an INR <1.3 prior to surgery

- Fibrinogen level <150 mg/dL on initial post cardiopulmonary bypass labs

- Antithrombin 3 level < 80% control (preoperative)

- Are undergoing emergency open heart-surgery

- Cardiopulmonary bypass time is expected to be < 30 minutes

- Age < 18 years of age

- Are pregnant