| 18617125 |
Ilyas C, Beyer GM, Dutton RP, Scalea TM, Hess JR: Recombinant factor VIIa for warfarin-associated intracranial bleeding. . J Clin Anesth. 2008 Jun;20(4):276-9.
STUDY OBJECTIVE: To examine the efficacy of recombinant factor VIIa (rVIIa) in reversing warfarin-induced coagulopathy in trauma patients presenting with intracranial hemorrhage (ICH). DESIGN: Retrospective, cohort-controlled database review. SETTING: Level 1, university-affiliated trauma center. PATIENTS: 54 patients presenting with ICH associated with chronic warfarin therapy, 30 of whom were treated with rVIIa, and the other 24 patients treated conventionally. MEASUREMENTS: We examined initial and subsequent coagulation studies (prothrombin time, international normalized ratio [INR]), blood product requirement, and clinical outcome, including time to reverse anticoagulation, duration of reversal, and subsequent mortality. MAIN RESULTS: Patients treated with rVIIa required significantly less plasma (4 vs 7 units) to correct their INR, and corrected in a much shorter period of time (2.4 vs 10 hrs). The duration of corrected INR after rVIIa was dose-dependent. CONCLUSIONS: Factor rVIIa provides prompt correction of the INR of dose-dependent duration in patients with ICH intracranial hemorrhage associated with warfarin use. |
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