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Makris M, van Veen JJ, Maclean R: Warfarin anticoagulation reversal: management of the asymptomatic and bleeding patient. J Thromb Thrombolysis. 2010 Feb;29(2):171-81.
The management of patients with supra-therapeutic INR in a common clinical problem. The risk of bleeding is influenced by the intensity, variability and duration of anticoagulation, patient age, presence of co-morbidities and concomitant drug therapy. For the asymptomatic patient, warfarin discontinuation is all that is usually required but for individuals at high risk of bleeding and those with INR > 10, oral vitamin K administration is recommended. In the presence of major bleeding, treatment with intravenous vitamin K and prothrombin complex concentrate is the most effective therapy. |
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