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Aetiology
Cohort study
Prothrombin complex concentrate safely reverses warfarin-related bleeding
  1. Huyen Tran1,
  2. Sanjeev Chunilal2
  1. 1 Department of Clinical Haematology, The Alfred Hospital, Melbourne, Australia;
  2. 2 Department of Clinical Haematology, Monash Medical Centre, Melbourne, Australia
  1. Correspondence to Dr Huyen Tran, Department of Clinical Haematology, The Alfred Hospital, 55 Commercial Road, Melbourne, VIC 3004, Australia; huyen.tran{at}monash.edu

http://dx.doi.org/10.1136/eb-2013-101523

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    Commentary on: Hickey M, Gatien M, Taljaard M, et al. Outcomes of urgent warfarin reversal with frozen plasma versus prothrombin complex concentrate in the emergency department. Circulation 2013;128:360–4.OpenUrlAbstract/FREE Full Text

    Context

    The incidence of major bleeding among patients receiving warfarin ranges from 1.35% to 3.4%, and intracranial haemorrhage (ICH) occurs in up to 0.7% of cases/annum.1 Therefore, effective strategies for warfarin reversal in patients with major bleeding are important. Historically, only fresh frozen plasma (FFP) and intravenous vitamin K1 have been available for emergency reversal, neither of which immediately restores vitamin K-dependent coagulation factors.2 FFP administration is often associated with lengthy delays and well-described potential risks.

    Prothrombin complex concentrates (PCC) are plasma derived, virally inactivated clotting factors that can be used for reversing warfarin coagulopathy. They can broadly …

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