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首页> 外文期刊>Internal medicine journal >Prothrombin complex concentrates used alone in urgent reversal of warfarin anticoagulation
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Prothrombin complex concentrates used alone in urgent reversal of warfarin anticoagulation

机译：凝血酶原复合物浓缩物单独用于华法林抗凝的紧急逆转

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Background: Prothrombinex-VF (a three-factor prothrombin complex concentrate) contains little factor VII. Therefore, the Warfarin Reversal Consensus Guidelines from 2004 published by The Australasian Society of Haemostasis and Thrombosis recommend that it be administered with fresh frozen plasma to reverse warfarin anticoagulation. Aim: To evaluate the efficacy and safety of Prothrombinex-VF used alone in warfarin reversal. Methods: Adult patients requiring urgent reversal of warfarin anticoagulation were defined as having achieved complete (target international normalized ratio (INR) <1.4) or partial reversal (target INR 1.4-2.0) of their anticoagulation. Prothrombinex-VF was given at doses of between 25 and 50IU/kg based on the intent of reversal and an INR was obtained 30min post infusion. Results: A total of 50 patients (mean age 72years, range 32-85years) was included. The median initial INR in the complete reversal arm (n= 35) was 3.5 (range 1.7-20) with 91% achieving the target INR (mean 1.1, range 0.9-1.4). In the partial reversal arm (n= 15) the mean initial INR was 5.6 (range 2.5-12) with 93% achieving the target INR (mean 1.6, range 1.4-2.2). There were no adverse effects attributed to Prothrombinex-VF. Conclusions: Prothrombinex-VF is very effective and safe when used alone to reverse warfarin anticoagulation. The supplementary use of fresh frozen plasma in these patients is not required. A review of the current Warfarin Reversal Consensus Guidelines is needed.
机译：背景：凝血酶原-VF（三因子凝血酶原复合物浓缩物）几乎不含VII因子。因此，澳大利亚止血和血栓形成协会发布的2004年《华法林逆转共识指南》建议将其与新鲜的冷冻血浆一起使用，以逆转华法林抗凝作用。目的：评估单独使用Prothrombinex-VF在华法林逆转中的疗效和安全性。方法：将需要紧急逆转华法林抗凝治疗的成年患者定义为已经完全或部分逆转（抗凝目标INR 1.4-2.0）或部分逆转（抗凝目标INR 1.4-2.0）。基于逆转的意图，以25至50IU / kg的剂量给予Prothrombinex-VF，并在输注后30分钟获得INR。结果：总共纳入了50例患者（平均年龄72岁，范围32-85岁）。完全逆转臂中的初始INR中位数（n = 35）为3.5（范围1.7-20），其中91％达到目标INR（平均值1.1，范围0.9-1.4）。在部分逆转臂（n = 15）中，平均初始INR为5.6（范围2.5-12），其中93％达到了目标INR（平均值1.6，范围1.4-2.2）。没有归因于Prothrombinex-VF的不良反应。结论：单独使用Prothrombinex-VF逆转华法林抗凝治疗是非常有效和安全的。不需要在这些患者中补充使用新鲜的冷冻血浆。需要对当前的《华法林逆转共识指南》进行审查。

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