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Prothrombin Complex Concentrates-Reply

Richard DeWitt, MD; Donald Feinstein, MD
Arch Intern Med. 1978;138(5):827. doi:10.1001/archinte.1978.03630290107046.
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In Reply.—  We appreciate the comments of Dr Blatt and associates. We would agree that these concentrates are less effective than two or three years ago and would point out to Dr Blatt and his associates that the communication was submitted for publication one year prior to its publication. During this period of time, it has become increasingly evident that the prothrombin complex concentrates have been "cleaned up" and are now less potent and less effective than before. However, the fact remains that whatever procoagulant material was present in Konyne in 1974 resulted in immediate hemostasis in a visible massively bleeding wound. We emphasize the latter, since there have been few reported instances where the degree of external bleeding could be evaluated after the administration of Konyne.We believe that our major disagreement with Dr Blatt and his associates revolves around the term "uncontrollable bleeding." Initially, our patient had received


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