Prothrombin Complex Concentrates for Perioperative Vitamin K Antagonist and Non-vitamin K Anticoagulant Reversal

Anesthesiology
Jerrold H LevyTruman J Milling

Abstract

Vitamin K antagonist therapy is associated with an increased bleeding risk, and clinicians often reverse anticoagulation in patients who require emergency surgical procedures. Current guidelines for rapid anticoagulation reversal for emergency surgery recommend four-factor prothrombin complex concentrate and vitamin K coadministration. The authors reviewed the current evidence on prothrombin complex concentrate treatment for vitamin K antagonist reversal in the perioperative setting, focusing on comparative studies and in the context of intracranial hemorrhage and cardiac surgery. The authors searched Cochrane Library and PubMed between January 2008 and December 2017 and retrieved 423 English-language papers, which they then screened for relevance to the perioperative setting; they identified 36 papers to include in this review. Prothrombin complex concentrate therapy was consistently shown to reduce international normalized ratio rapidly and control bleeding effectively. In comparative studies with plasma, prothrombin complex concentrate use was associated with a greater proportion of patients achieving target international normalized ratios rapidly, with improved hemostasis. No differences in thromboembolic event rates were s...Continue Reading

References

Sep 28, 1999·Thrombosis Research·M Köhler
Aug 7, 2007·The American Journal of Medicine·Margaret C FangDaniel E Singer
Jan 23, 2008·Journal of Thrombosis and Haemostasis : JTH·I PabingerUNKNOWN Beriplex P/N Anticoagulation Reversal Study Group
Aug 12, 2008·International Journal of Clinical Practice·U KalinaS Schulte
Oct 24, 2008·Anesthesiology·Jerrold H LevyWulf Dietrich
Sep 30, 2009·Annals of Hematology·Ingrid PabingerUNKNOWN Beriplex P/N Anticoagulation Reversal Study Group
Aug 12, 2010·Anesthesiology·Jerrold H LevyMarc S Azran
Nov 30, 2010·Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics·Yoshinari MorimotoTakeshi Nakatani
Jun 16, 2011·British Journal of Haematology·David KeelingUNKNOWN British Committee for Standards in Haematology
Mar 28, 2012·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Manuela C CarvalhoLuis C Ribeiro
Apr 17, 2012·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Miranda WozniakJanis Bormanis
Jan 26, 2013·Journal of Thrombosis and Haemostasis : JTH·K HalbritterS M Schellong
May 15, 2013·Interactive Cardiovascular and Thoracic Surgery·Rahul KarMichael S Firstenberg
May 16, 2013·The Annals of Thoracic Surgery·Marco RanucciUNKNOWN Surgical and Clinical Outcome Research (SCORE) Group
Aug 27, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Lindsay HurlburtAdriaan van Rensburg
Sep 26, 2013·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Santiago R Leal-NovalManuel Muñoz
Feb 27, 2014·Acta neurochirurgica·Christopher BeynonOliver W Sakowitz
Apr 10, 2014·Case Reports in Anesthesiology·Conor Skerritt, Stephen Mannion
Apr 16, 2014·World Journal of Emergency Surgery : WJES·Scott A ChapmanRobert M Roach
Jun 24, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Vijay YanamadalaBrooke Swearingen
Aug 12, 2014·Journal of Neurosurgical Anesthesiology·Christopher BeynonOliver W Sakowitz
Aug 27, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Thorsten SteinerUNKNOWN European Stroke Organisation

❮ Previous
Next ❯

Citations

Jan 3, 2019·Current Opinion in Anaesthesiology·Benedikt TremlBettina Schenk
Apr 16, 2019·Seminars in Cardiothoracic and Vascular Anesthesia·Brigid C FlynnNatalia S Ivascu
Jun 28, 2019·Anesthesiology·Ashley C Brown, Jerrold H Levy
Mar 1, 2019·Current Opinion in Anaesthesiology·Benedikt TremlBettina Schenk
Dec 2, 2020·Journal of Clinical Medicine·Johannes GratzOliver Grottke
Oct 21, 2021·Current Opinion in Anaesthesiology·Jeans M Santana, Ethan Y Brovman

❮ Previous
Next ❯

Related Concepts

Related Feeds

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.