Representative curves from the thrombin generation assays. (A) Plasma thrombin generation, for assessment of hypercoagulability after PCC administration. Thrombin generation in platelet-poor plasma was assessed by means of the CAT according to standard in-house procedures, using 1pM tissue factor and 4μM phospholipids to trigger the assay. Representative curves are shown for baseline, hemodilution, and 30, 60, and 120 minutes after trauma, following the administration of saline (top row: open curves); 35 IU/kg PCC (middle row: light gray curves); and 50 IU/kg PCC (bottom row: dark gray curves). Independent of the dose of PCC, plasma thrombin generation was characterized by a prolonged time to tail, indicating attenuated inhibition of coagulation. (B) 50 IU/kg PCC can induce a hypercoagulable state associated with DIC. Top row: thrombin generation curves in plasma from an animal receiving 50 IU/kg PCC and not developing DIC. Bottom row: thrombin generation curves in plasma from an animal receiving 50 IU/kg PCC and developing DIC (PCC50_DIC+). Remarkably, no difference was observed in thrombin generation before and after hemodilution.