Reversal of Warfarin-Induced Hemorrhage in the Emergency Department

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Reversal of Warfarin-Induced Hemorrhage in the Emergency Department

Warfarin, an oral vitamin K antagonist, is used to prevent arterial and venous thromboembolism in patients suffering from a multitude of diseases. In 2004, 31 million warfarin prescriptions were dispensed in the United States. Warfarin inhibits the activation of the vitamin K-dependent clotting factors (Factors II, VII, IX, and X) and regulatory proteins (proteins C, S, and Z). It is one of the...

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Rapid reversal of warfarin-associated hemorrhage in the emergency department by prothrombin complex concentrates.

Life-threatening warfarin-associated hemorrhage is common, with a high mortality. In the United States, the most commonly used therapies--fresh frozen plasma and vitamin K--are slow and unpredictable and can result in volume overload. Outside of the United States, prothrombin complex concentrates are often used instead; these pooled plasma products reverse warfarin anticoagulation in minutes ra...

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Outcomes of urgent warfarin reversal with frozen plasma versus prothrombin complex concentrate in the emergency department.

BACKGROUND Physicians reverse patients' warfarin anticoagulation with frozen plasma or prothrombin complex concentrate. Our objective was to determine adverse event frequency after urgent reversal with frozen plasma versus the prothrombin complex concentrate Octaplex. METHODS AND RESULTS This natural before-after retrospective cohort study in 2 tertiary care emergency departments compared ant...

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Emergency reversal of anticoagulation after intracerebral hemorrhage.

BACKGROUND AND PURPOSE Although intracerebral hemorrhage is one of the most serious complications during oral anticoagulant therapy, there are no guidelines on emergency treatment with respect to reversal of anticoagulation effect in these patients. METHODS We retrospectively compared laboratory data and clinical features in 17 cases of anticoagulant-related intracerebral hemorrhage treated w...

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Poor prognosis in warfarin-associated intracranial hemorrhage despite anticoagulation reversal.

BACKGROUND AND PURPOSE Anticoagulant-associated intracranial hemorrhage (aaICH) presents with larger hematoma volumes, higher risk of hematoma expansion, and worse outcome than spontaneous intracranial hemorrhage. Prothrombin complex concentrates (PCCs) are indicated for urgent reversal of anticoagulation after aaICH. Given the lack of randomized controlled trial evidence of efficacy, and the p...

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ژورنال

عنوان ژورنال: Western Journal of Emergency Medicine

سال: 2011

ISSN: 1936-900X,1936-9018

DOI: 10.5811/westjem.2011.3.2051