A promising new alternative for the rapid reversal of warfarin coagulopathy in traumatic intracranial hemorrhage

American Journal of Surgery
Marian N SafaouiDaniel R Margulies

Abstract

Internationally, Factor IX complex (FIX complex) has been used to correct warfarin-induced coagulopathy. We present our experience with 28 patients using FIX complex. A retrospective chart review was conducted between November 2002 and July 2006 on patients with warfarin-induced coagulopathy. We recorded the dose and timing of FIX complex, serial international normalized ratios (INRs), early adverse events, and patient outcome. Twenty-eight patients met criteria. The mean INR on admission was 5.1, and after FIX complex infusion was reduced significantly to 1.9 (P = .008). Eleven patients had a repeat INR drawn within 30 minutes after FIX complex infusion. The mean time to correction was 13.5 minutes. There were no early thrombotic events or allergic reactions. FIX complex results in an immediate reversal of coagulopathy within 15 minutes after administration. Its use should be considered as an alternative treatment to fresh-frozen plasma and recombinant Factor VIIa. Prospective randomized trials are needed to confirm these findings.

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Citations

May 15, 2013·Interactive Cardiovascular and Thoracic Surgery·Rahul KarMichael S Firstenberg
May 3, 2013·Journal of Neurosurgery·Michael W ParraCandace R Kokaram
Apr 16, 2014·World Journal of Emergency Surgery : WJES·Scott A ChapmanRobert M Roach
Jul 28, 2012·Clinical Neurology and Neurosurgery·Katherine P CabralDavid B Seder
Apr 14, 2016·Critical Care : the Official Journal of the Critical Care Forum·Rolf RossaintDonat R Spahn
Dec 3, 2014·American Journal of Surgery·Kazuhide MatsushimaDemetrios Demetriades
Jul 22, 2011·The Annals of Pharmacotherapy·Scott A ChapmanMelissa A L Thorson
Dec 29, 2012·The Journal of Trauma and Acute Care Surgery·Bellal JosephPeter Rhee
Jul 16, 2014·The Journal of Oral Implantology·Cassiano Costa Silva PereiraRoberta Okamoto
Apr 12, 2012·The Journal of Trauma and Acute Care Surgery·Bellal JosephPeter Rhee
Jun 10, 2017·International Anesthesiology Clinics·Clinton P JonesGiles R Nordmann
Sep 24, 2020·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·Muhammad OsamaSyeda Ramsha Zaidi

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