<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-0420</journal-id>
<journal-title><![CDATA[Revista Uruguaya de Cardiología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev.Urug.Cardiol.]]></abbrev-journal-title>
<issn>1688-0420</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Uruguaya de Cardiología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-04202026000101401</article-id>
<article-id pub-id-type="doi">10.29277/cardio.41.1.3</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[¿Es el momento de reemplazar el plasma por el concentrado de complejo protrombínico en la cirugía cardíaca?]]></article-title>
<article-title xml:lang="en"><![CDATA[Is it time to replace plasma with prothrombin complex concentrate in cardiac surgery?]]></article-title>
<article-title xml:lang="pt"><![CDATA[É hora de substituir o plasma por concentrado de complexo de protrombina em cirurgia cardíaca?]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Berro]]></surname>
<given-names><![CDATA[Maximiliano]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de la República Facultad de Medicina Unidad Académica de Hemoterapia y Medicina Transfusional, Hospital de Clínicas]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Uruguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2026</year>
</pub-date>
<volume>41</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-04202026000101401&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-04202026000101401&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-04202026000101401&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El sangrado posoperatorio en cirugía cardíaca es una situación frecuente y se asocia a una peor evolución clínica y mayor utilización de recursos. Aunque el plasma fresco congelado ha sido la estrategia tradicional para reponer factores de la coagulación cuando se constata una coagulopatía, su eficacia clínica es modesta y depende de volúmenes elevados, con incremento en el riesgo de complicaciones. El concentrado de complejo protrombínico aporta una reposición rápida de los factores vitamina K dependientes en un pequeño volumen. La evidencia reciente -incluidos metaanálisis, estudios observacionales y ensayos aleatorizados- muestra que el concentrado de complejo protrombínico reduce el sangrado y la necesidad de transfusión de sangre sin aumentar los eventos tromboembólicos. En pacientes con sangrado significativo y coagulopatía documentada (INR elevado y/o ROTEM alterado), el concentrado de complejo protrombínico debe considerarse como la opción terapéutica preferible, dentro de algoritmos protocolizados guiados por pruebas de laboratorio o viscoelásticas de la coagulación. Persisten incertidumbres sobre la dosis óptima, costo-efectividad y seguridad en subgrupos de alto riesgo trombótico, que justifican investigación adicional.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Postoperative bleeding after cardiac surgery is a common occurrence and is associated with a poorer clinical outcome and increased resource utilization. Although fresh frozen plasma has traditionally been used to replace coagulation factors in cases of coagulopathy, its clinical efficacy is modest and depends on large volumes, increasing the risk of complications. Prothrombin complex concentrate (PCC) provides rapid replacement of vitamin K, dependent coagulation factors in a small volume. Recent evidence -including meta-analyses, observational studies, and randomized controlled trials- shows that PCC reduces bleeding and the need for blood transfusions without increasing thromboembolic events. In patients with significant bleeding and documented coagulopathy (elevated INR and/or abnormal ROTEM results), PCC should be considered as the preferred treatment option, within standardized protocols guided by laboratory or viscoelastic coagulation tests. Uncertainties remain regarding the optimal dose, cost-effectiveness, and safety in high-risk thromboembolic subgroups, which warrant further research.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: O sangramento pós-operatório em cirurgia cardíaca é uma condição comum e está associado a um pior desfecho clínico e ao aumento da utilização de recursos. Embora o plasma fresco congelado tenha sido a estratégia tradicional para a reposição dos fatores de coagulação quando a coagulopatia é detectada, sua eficácia clínica é modesta e depende de altos volumes, com risco aumentado de complicações. O concentrado de complexo de protrombina proporciona rápida reposição dos fatores dependentes de vitamina K em um pequeno volume. Evidências recentes -incluindo meta-análises, estudos observacionais e ensaios clínicos randomizados- mostram que o concentrado de complexo de protrombina reduz o sangramento e a necessidade de transfusão sanguínea sem aumentar os eventos tromboembólicos. Em pacientes com sangramento significativo e coagulopatia documentada (INR elevado e/ou ROTEM alterado), o concentrado de complexo de protrombina deve ser considerado a opção terapêutica preferencial dentro de algoritmos protocolados guiados por testes laboratoriais ou de coagulação viscoelástica. Permanecem incertezas quanto à dose ideal, custo-efetividade e segurança em subgrupos trombóticos de alto risco, justificando pesquisas adicionais.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[CIRUGÍA CARDÍACA]]></kwd>
<kwd lng="es"><![CDATA[SANGRADO CRÍTICO]]></kwd>
<kwd lng="es"><![CDATA[PLASMA]]></kwd>
<kwd lng="es"><![CDATA[CONCENTRADO DE COMPLEJO PROTROMBÍNICO]]></kwd>
<kwd lng="en"><![CDATA[CARDIAC SURGERY]]></kwd>
<kwd lng="en"><![CDATA[CRITICAL BLEEDING]]></kwd>
<kwd lng="en"><![CDATA[PLASMA]]></kwd>
<kwd lng="en"><![CDATA[PROTHROMBIN COMPLEX]]></kwd>
<kwd lng="en"><![CDATA[CONCENTRATE]]></kwd>
<kwd lng="pt"><![CDATA[CIRURGIA CARDÍACA]]></kwd>
<kwd lng="pt"><![CDATA[SANGRAMENTO CRÍTICO]]></kwd>
<kwd lng="pt"><![CDATA[PLASMA]]></kwd>
<kwd lng="pt"><![CDATA[CONCENTRADO DE COMPLEXO DE PROTROMBINA]]></kwd>
</kwd-group>
</article-meta>
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