Urgent reversal of vitamin K antagonist therapy.

摘要: In the developed world, an increasing number of patients receive therapy with vitamin K antagonists (VKA). This group poses additional challenge in perioperative management emergency surgery and trauma. The present review offers a detailed description some treatment options for reversal VKA therapy. Optimal anticoagulated patient requires well-balanced intervention securing reduced risk haemorrhagic surgical complications as well optimal anticoagulation post-operatively without exposing to increased thromboembolic complications. following factors must be considered VKA-treated scheduled surgery: (1) indication therapy, including events when International normalized ratio (INR) is reduced, (2) type surgery, (3) pharmacodynamic/-kinetic profile used revert Therapeutic acute include: K, fresh frozen plasma (FFP), prothrombin complex concentrate (PCC) perhaps activated recombinant factor VII. PCC relatively new drug European countries clinical experience limited compared use FFP. Reversal faster more efficient FFP, but there are currently no randomized studies demonstrating improved outcome.