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Four factor prothrombin complex concentrate for warfarin reversal in patients with left ventricular assist devices
- Source :
- Journal of Thrombosis and Thrombolysis. 46:180-185
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Continuous flow left ventricular assist devices (CF-LVAD) require therapeutic anticoagulation which is often interrupted for procedures or bleeding. Prior to the availability of four factor prothrombin complex concentrate (4F-PCC) in the United States, warfarin was held and its effects reversed by vitamin K or fresh frozen plasma. We evaluated the use of 4F-PCC for temporary warfarin reversal in patients with CF-LVADs and assessed outcomes. This analysis is a retrospective study of CF-LVAD patients who received 4F-PCC for warfarin reversal in the setting of bleeding or need for urgent or elective procedures. Primary outcome assessments included feasibility of administration in elective versus emergent situations, safety measured as incidence of thrombotic events, and change in INR after administration. In total, 37 CF-LVAD patients received 49 4F-PCC administrations. The average 4F-PCC dose was 1842 units (range 518–4292 units), or 22 units/kg (range 5.8–58 units/kg). 4F-PCC significantly decreased the mean INR from 2.9 to 1.7 (p
- Subjects :
- Heart Ventricles
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Drug Interactions
International Normalized Ratio
Myocardial infarction
Stroke
Aged
Aged, 80 and over
business.industry
Incidence (epidemiology)
Warfarin
030208 emergency & critical care medicine
Retrospective cohort study
Hematology
Middle Aged
medicine.disease
Prothrombin complex concentrate
Thrombosis
Blood Coagulation Factors
Treatment Outcome
Anesthesia
Heart-Assist Devices
Fresh frozen plasma
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 1573742X and 09295305
- Volume :
- 46
- Database :
- OpenAIRE
- Journal :
- Journal of Thrombosis and Thrombolysis
- Accession number :
- edsair.doi.dedup.....5a840e3a01cdf12305bd18800c6237ea
- Full Text :
- https://doi.org/10.1007/s11239-018-1680-8