Pasienter som ikke trenger akutt reversering av behandling med vitamin K antagonister kan ofte behandles med vitamin K. Protrombinkonsentrat bør kun brukes til pasienter
med alvorlig blødning eller til pasienter som trenger akutt reversering av vitamin K antagonister ved ikke-planlagt kirurgisk behandling. Plasmatransfusjon bør i denne settingen bare benyttes dersom protrombinkomplekskonsentrat ikke er tilgjengelig eller er kontraindisert. Plasmatransfusjon er ikke anbefalt for normalisering av INR hos ikke-blødende pasienter. En lett forhøyet INR predikerer ikke en økt risiko for blødning.
Referanser:
- Green L et al. British Society of Haematology Guidelines on the spectrum of fresh frozen plasma and cryoprecipitate products: their handling and use in various patient groups in the absence of major bleeding. British Journal of Haematology, 2018.
- Abdel-Wahab OI et al. Effect of fresh-frozen plasma transfusion on prothrombin time and bleeding in patients with mild coagulation abnormalities. Transfusion. 2006.
- Szczepiorkowski ZM, et al. Transfusion guidelines: when to transfuse. Hematology Am Soc Hematol Educ Program. 2013.
- Holbrook A, et al. Evidence-Based Management of Anticoagulant Therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012.\
- Keeling D, et al. Guidelines on oral anticoagulation with warfarin – fourth edition. Br J Haematol. 2011.
- National Advisory Committee on Blood and Blood Products (NAC). Prothrombin Complex Concentrates 2014.
- Tinmouth A Evidence for a rationale use of frozen plasma for the treatment and prevention of bleeding. Transfus Apher Sci 2012 .
- Segal JB et al. Paucity of studies to support that abnormal coagulation test results predict bleeding in the setting of invasive procedures: an evidence-based review. Transfusion, 2005.
Relevante lenker: