Table 4. Selected Reports of PCC Use in Infants and Children Undergoing Cardiac Surgery.

Author and reference	Study design and cohort	Outcomes
Giorni et al [47]	Retrospective study cohort of 14 patients, ranging in age from 8 to 67 days, compared to 11 case-matched controls.	PCCs administered after CPB. PCC patients had lower chest tube output in the first 24 postoperative hours and decreased transfusion requirements although these did not reach statistical significance.
Navaratnam et al [48]	Five patients, ranging in age from 7 to 23 years, for combined liver-heart transplantation.	PCCs used as part of their perioperative management protocol following large volume transfusions (1-3 blood volumes). Four of the five patients also received an antifibrinolytic agent and rFVIIa.
Rybka et al [49]	Prospective cohort of 15 children, 9 months to 3 years of age. PCC dosing of 30-50 IU/kg.	Clinical bleeding after heparin reversal with protamine. Clinical hemostasis was achieved in 13 of 15 patients.
Jooste et al [50]	Retrospective cohort of five neonates and one infant.	3F-PCC used in conjunction with rFVIIa (four patients) and AT-III replacement if level was less than 70%. Thrombotic complications noted in two patients.
Sisti et al [51]	Cohort of patients for heart transplantation, being supported preoperatively with a ventricular assist device.	Anticoagulation reversed with PCC or FFP. Patients who received PCC had decreased transfusion requirements.
Velik-Salchner et al [52]	Propensity score matching of 210 children who received FC and PCC compared to standard treatment with FFP.	FC/PCC was well tolerated and provided effective clinical hemostasis. Outcomes were non-inferior to FFP.

PCC: prothrombin complex concentrate; CPB: cardiopulmonary bypass; rFVIIa: recombinant activated factor VII; AT-III: anti-thrombin III; FFP: fresh frozen plasma; FC: fibrinogen concentrate.