Use of Recombinant Factor VIIa in Patients With Warfarin-Associated Intracranial Hemorrhage

摘要: Introduction: Warfarin-associated intracranial hemorrhage (ICH) requires rapid normalization of clotting function. Current therapies are associated with significant complications and/or prolonged time to correction coagulopathy. Recombinant factor VIIa (FVIIa) might allow faster and safer Methods: This article presents a retrospective chart review all patients warfarin-associated ICH treated in neurology/neurosurgery intensive care unit over an 11-month period. Results: All were rapidly reverse the warfarin effect. Fifteen received vitamin K fresh frozen plasma (FFP) alone (FFP group). Twelve also FVIIa (FVIIa The median times from presentation international ratio (INR) less than 1.3 32.2 8.8 hours FFP groups, respectively (p=0.016). INR normalized slowly (at 110 130 hours, respectively) two end-stage renal failure who given FVIIa, one whom developed disseminated intravascular coagulation after three doses FVIIa. No other occurred administration. One patient group severe pulmonary edema. Conclusion: may be effective adjunct warfarin-related ICH, facilitating decreasing requirements. A prospective, randomized trial is needed confirm these preliminary findings determine whether there clinical benefit.