Title: Reversal of Vitamin K Antagonists in Intracranial Hemorrhage<br/>Author: Daniel Haase<br/><a href='http://umem.org/profiles/faculty/1447/'>[Click to email author]</a><hr/><p>
The Neurocritical Care Society and Society of Critical Care Medicine just came out with new <u>Guidelines for Reversal of Antithrombotics in Intracranial Hemorrhage</u> (ICH) [1]</p>
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--PCC is now recommended over FFP in reversal of vitamin K antagonists (VKA) with elevated INR. Either should be co-administered with 10mg IV vitamin K. (Strong recommendation, moderate quality evidence)</p>
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<strong>TAKE AWAY: </strong>PCC should be probably be given over FFP in VKA-ICH when available</p>
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<fieldset><legend>References</legend>
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1. <a href="https://www.ncbi.nlm.nih.gov/pubmed/27858808" style="font-family: arial, helvetica, clean, sans-serif; font-size: 1.108em; color: rgb(100, 42, 143); border: 0px;">Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: Executive Summary. A Statement for Healthcare Professionals From the Neurocritical Care Society and the Society of Critical Care Medicine.</a> <span style="font-size: 1.077em; color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif;">Frontera JA, Lewin JJ 3rd, et al. </span><span style="font-size: 0.923em; color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif;">Crit Care Med. 2016 Dec;44(12):2251-2257.</span><span style="font-size: 0.923em; color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif;"> </span></p>
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2. <a href="https://www.ncbi.nlm.nih.gov/pubmed/27302126" style="font-family: arial, helvetica, clean, sans-serif; font-size: 1.108em; color: rgb(100, 42, 143); border: 0px;">Fresh frozen plasma versus prothrombin complex concentrate in patients with intracranial haemorrhage related to vitamin K antagonists (INCH): a randomised trial.</a> <span style="font-size: 1.077em; color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif;">Steiner T, Poli S, et al. </span><span style="font-size: 0.923em; color: rgb(0, 0, 0); font-family: arial, helvetica, clean, sans-serif;">Lancet Neurol. 2016 May;15(6):566-73.</span></p>
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