ArticleBlood transfusion = Trasfusione del sangue2011
Emergency reversal of anticoagulation with a three-factor prothrombin complex concentrate in patients with intracranial haemorrhage.
Article in Blood transfusion = Trasfusione del sangue, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 70 citations in OpenAlex.
- Management of bleeding and coagulopathy following major trauma: an updated European guideline.Critical care (London, England) · 2013Pooled it
- Emergency reversal of anticoagulation with vitamin K antagonists with 3-factor prothrombin complex concentrates in patients with major bleeding.Journal of thrombosis and thrombolysis · 2013Trial
- Golden hour management in the patient with intraparenchymal cerebral hemorrhage: an Italian intersociety document.Journal of anesthesia, analgesia and critical care · 2025Review
- Reversal of anticoagulation in patients with intracerebral haemorrhage related to oral anticoagulants: State of the evidence.European stroke journal · 2025Review
- The outcomes of three-factor prothrombin complex concentrate (3F-PCC) in warfarin anticoagulation reversal: a prospective, single-arm, open-label, multicentre study.Journal of thrombosis and thrombolysis · 2021Article
- A Retrospective Comparison of 3-Factor Prothrombin Complex Concentrate Products for Warfarin Reversal.The Neurohospitalist · 2020Article
- Is Coagulopathy an Appropriate Therapeutic Target During Critical Illness Such as Trauma or Sepsis?Shock (Augusta, Ga.) · 2017Review
- Clinical effectiveness and safety outcomes associated with prothrombin complex concentrates.Journal of thrombosis and thrombolysis · 2016Article
- 3-Factor Versus 4-Factor Prothrombin Complex Concentrate for Warfarin Reversal in Severe Bleeding: A Multicenter, Retrospective, Propensity-Matched Pilot Study.Journal of thrombosis and thrombolysis · 2016Article
- Prothrombin Complex Concentrates for Bleeding in the Perioperative Setting.Anesthesia and analgesia · 2016Review
- Recommendations for the implementation of a Patient Blood Management programme. Application to elective major orthopaedic surgery in adults.Blood transfusion = Trasfusione del sangue · 2016Article
- Use of prothrombin complex concentrate in warfarin anticoagulation reversal in the emergency department: a quality improvement study of administration delays.BMC health services research · 2015Article
- Evaluation of a fixed, weight-based dose of 3-factor prothrombin complex concentrate without adjunctive plasma following warfarin-associated intracranial hemorrhage.Neurocritical care · 2014Article
- Role of prothrombin complex concentrate in perioperative coagulation therapy.Journal of intensive care · 2014Review
- Comparison of 3-Factor Prothrombin Complex Concentrate and Low-Dose Recombinant Factor VIIa for Warfarin Reversal.World journal of emergency surgery : WJES · 2014Article
- Reversal of oral anticoagulation.Pharmacotherapy · 2013Review
- Reversal of Vitamin K Antagonist (VKA) effect in patients with severe bleeding: a French multicenter observational study (Optiplex) assessing the use of Prothrombin Complex Concentrate (PCC) in current clinical practice.Critical care (London, England) · 2012Observational
- Emergency reversal of anticoagulation: from theory to real use of prothrombin complex concentrates. A retrospective Italian experience.Blood transfusion = Trasfusione del sangue · 2012Article
- Three- or four-factor prothrombin complex concentrate for emergency anticoagulation reversal: what are we really looking for?Blood transfusion = Trasfusione del sangue · 2011Article
- Three or four factor prothrombin complex concentrate for emergency anticoagulation reversal?Blood transfusion = Trasfusione del sangue · 2011Article
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntracranial haemorrhage is a serious and potentially fatal complication of oral anticoagulant therapy. Prothrombin complex concentrates can substantially shorten the time needed to reverse the effects of oral anticoagulants. The aim of this study was to determine the efficacy and safety of a prothrombin complex concentrate for rapid reversal of oral anticoagulant therapy in patients with intracranial haemorrhage.
methodsPatients receiving oral anticoagulant therapy and suffering from acute intracranial haemorrhage were eligible for this prospective cohort study if their International Normalised Ratio (INR) was higher than or equal to 2.0. The prothrombin complex concentrate was infused at doses of 35-50 IU/kg, stratified according to the initial INR.
resultsForty-six patients (25 males; mean age: 75 years; range 38-92 years) were enrolled. The median INR at presentation was 3.5 (range, 2-9). At 30 minutes after administration of the prothrombin complex concentrate, the median INR was 1.3 (range, 0.9-3), and the INR then declined to less than or equal to 1.5 in 75% of patients. The benefit of the prothrombin complex concentrate was maintained for a long time, since the median INR remained lower than or equal to 1.5 (median, 1.16; range, 0.9-2.2) at 96% of all post-infusion time-points up to 96 hours. No thrombotic complications or significant adverse events were observed during hospitalisation; six patients (13%) died, but none of these deaths was judged to be related to administration of the prothrombin complex concentrate.
conclusionsProthrombin complex concentrates are an effective, rapid and safe treatment for the urgent reversal of oral anticoagulation in patients with intracranial haemorrhage. Broader use of prothrombin complex concentrates in this clinical setting appears to be appropriate.
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