Surgical Considerations for Kcentra (prothrombin complex concentrate) a Factor Replacement for Acute Surgical Procedures
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2019
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Abstract
There is a growing number of individuals receiving warfarin anticoagulation therapy in the United States, which increases the chances that anesthesia providers will provide care to this population. Receiving anticoagulation therapy places individuals at a high risk for bleeding complications when undergoing emergency surgery. Traditional treatment to lower supratherapeutic International Normalized Ratio (INR) has been Fresh Frozen Plasma (FFP) and vitamin K. However, receiving large volumes of FFP makes this population prone to several severe complications, which ultimately increase cost and decrease patient safety. Kcentra prothrombin complex concentrate (PCC) was approved in 2013 by the FDA and is able to fully reverse warfarin while avoiding the serious and costly side effects of FFP administration. The average volume of Kcentra needed to fully reverse warfarin was found to be only 11% of the total volume of FFP needed for full reversal. Kcentra was ultimately found to decrease surgical bleeding, which consequently decreased transfusion of blood products, overall cost of hospitalization, and adverse transfusion effects. The aim of this quantitative scholarly project was to develop an educational PowerPoint presentation with the purpose of increasing the knowledge base of 22 Advent Health University Student Registered Nurse Anesthetists. The student registered nurse anesthetist baseline knowledge was assessed by the completion of a 10- multiple choice question pre-test prior to the presentation. Following the presentation, a posttest (identical to pre-test) was given to assess a change in knowledge base. Statistical analysis was performed using a (paired t-test) on the mean pre- and posttest scores to determine the effectiveness of the educational PowerPoint presentation on increasing the knowledge base of the participants. The pretest standard deviation was 19.73855, while the posttest was 10.45502. The obtained T value was (-9.167) and is associated with p<.001 which is statistically significant.
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