title: How I treat warfarin-associated coagulopathy in patients with intracerebral hemorrhage.
abstract: Intracerebral hemorrhage in patients with warfarin-associated coagulopathy is an increasingly common life-threatening condition that requires emergent management. The evolution of therapeutic options in this setting, as well as recently published guidelines, has resulted in some heterogeneity in recommendations by professional societies. This heterogeneity can be attributed to lack of evidence-based support for plasma therapy; the variability in availability of prothrombin complex concentrates; the variability in the coagulation factor levels and contents of prothrombin complex concentrates; ambiguity about the optimal dose and route of administration of vitamin K; and the lack of standardized clinical care pathways, particularly in community hospitals, for the management of these critical care patients. In this review, we summarize the relevant literature about these controversies and present recommendations for management of patients with warfarin-associated coagulopathy and intracerebral hemorrhage.
authors.affiliation: Departments of Pathology and Medicine, Stanford University School of Medicine, Stanford, CA, USA. ltgoodno@stanford.edu
authors.forename: Lawrence Tim
authors.initials: LT
authors.lastname: Goodnough
authors.forename: Aryeh
authors.initials: A
authors.lastname: Shander
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000139:chemically induced* / Q000188:drug therapy*; D002543:Cerebral Hemorrhage / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D014812:Vitamin K / Q000627:therapeutic use*; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D000933:Antifibrinolytic Agents; D014812:Vitamin K; D014859:Warfarin