Thromboelastography-targeted management of severe coagulopathy and off-label use of four-factor prothrombin complex concentrate in an infant with massive bleeding

Proshad N. Efune, Gijo Alex, Janna M Journeycake, Sonia D. Mehta

Research output: Contribution to journalArticlepeer-review

Abstract

A 4-month-old girl initially presented to the pediatric ICU at 9 days old with multiorgan failure and cerebellar hemorrhage secondary to disseminated enteroviral infection and was eventually listed for liver transplant. Due to severe coagulopathy, she developed a hemothorax after line placement. Despite operative exploration and multiple recombinant factor VIIa doses, massive bleeding continued. The bleeding was finally controlled with thromboelastography-targeted platelet and cryoprecipitate transfusion in addition to four-factor prothrombin complex concentrate administration. This management strategy was invaluable in controlling bleeding from an iatrogenic cause.

Original languageEnglish (US)
Pages (from-to)170-173
Number of pages4
JournalBlood Coagulation and Fibrinolysis
Volume31
Issue number2
DOIs
StatePublished - Mar 1 2020
Externally publishedYes

Keywords

  • coagulopathy
  • four-factor prothrombin complex concentrate
  • liver failure
  • thromboelastography

ASJC Scopus subject areas

  • Hematology

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