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Use of 4-factor prothrombin complex concentrate in the treatment of a gastrointestinal hemorrhage complicated by

Terrance R McGovern1, Justin J McNamee1, Christopher Malabanan2

  • 1Department of Emergency Medicine, St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07503 USA.

International Journal of Emergency Medicine
|April 29, 2015
PubMed

Target-specific oral anticoagulants (TSOACs) provide patients and healthcare providers with an alternative to vitamin K antagonists (VKA). The TSOACs are of similar or superior efficacy to warfarin, but unlike VKAs, there are no approved 'antidotes' for rapid reversal of life-threatening bleeding on therapy. We report here the case of an 83-year-old gentleman, who presented to the emergency department with severe gastrointestinal hemorrhage and coagulopathy (hemoglobin: 5.3 g/dL and INR: 2.2) while on the direct thrombin inhibitor dabigatran. His coagulopathy reversed rapidly after administration of 4-factor prothrombin complex concentrate (4 F-PCC), and after initial administration of 2 units of packed red blood cells, no further product transfusions were required. He was discharged 4 days later without further complications.

Keywords:
DabigatranEmergency medicineProthrombin complex concentrateReversalTarget-specific oral anticoagulants

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