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October 17, 2008AnesthesiologyOpen Access

Perioperative Hemostatic Management of Patients Treated with Vitamin K Antagonists

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Key result

Prothrombin complex concentrates provide quicker correction of the international normalized ratio and improved bleeding control compared with fresh frozen plasma for rapid anticoagulation reversal.

Why the study?

Do prothrombin complex concentrates (PCCs) improve INR correction and bleeding control compared to fresh frozen plasma in patients requiring rapid reversal of vitamin K antagonists?

Population

Patients receiving oral anticoagulation therapy requiring rapid reversal of coagulopathy

Comparison

Prothrombin complex concentrates (PCCs) vs Fresh frozen plasma or recombinant activated…

Design

Review

Authors

JLJerrold H. LevyCardiac SurgeryKTKenichi A. TanakaUniversity of Maryland, BaltimoreWDWulf DietrichWestern University

Discussion

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Implication

May support PCC preference for urgent VKA reversal; leaves open randomized outcome trials.

Structured PICO

Do prothrombin complex concentrates (PCCs) improve INR correction and bleeding control compared to fresh frozen plasma in patients requiring rapid reversal of vitamin K antagonists?

P
Population
Patients receiving oral anticoagulation therapy (vitamin K antagonists) requiring rapid reversal of coagulopathy (e.g., emergency surgery or life-threatening bleeding)
I
Intervention
Prothrombin complex concentrates (PCCs)
C
Comparator
Fresh frozen plasma (FFP) or recombinant activated factor VII
O
Outcome
Correction of international normalized ratio (INR) and bleeding control

Prothrombin complex concentrates should be considered as an alternative to fresh frozen plasma for rapid reversal of vitamin K antagonists due to quicker INR correction and improved bleeding control.

Cite This Study

Levy et al. (2008) conducted a review in Coagulopathy in patients receiving oral anticoagulation therapy. Prothrombin complex concentrates (PCCs) vs. Fresh frozen plasma was evaluated. Prothrombin complex concentrates provide quicker correction of the international normalized ratio and improved bleeding control compared with fresh frozen plasma for rapid anticoagulation reversal.

synapsesocial.com/papers/6a79f347f48aafa9d7f37464https://doi.org/10.1097/aln.0b013e3181895bd8
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Emergency Oral Anticoagulant Reversal: The Relative Efficacy of Infusions of Fresh Frozen Plasma and Clotting Factor Concentrate on Correction of the Coagulopathy1997 · 408 citations
  2. 2Hematoma Growth and Outcome in Treated Neurocritical Care Patients With Intracerebral Hemorrhage Related to Oral Anticoagulant Therapy2006 · 335 citations
  3. 3Poor correlation of supratherapeutic international normalised ratio and vitamin K‐dependent procoagulant factor levels during warfarin therapy2005 · 35 citations
  4. 4Reversal of Warfarin-Induced Excessive Anticoagulation with Recombinant Human Factor VIIa Concentrate2002 · 276 citations
  5. 5Biochemical comparison of seven commercially available prothrombin complex concentrates2008 · 92 citations