Use of 4-factor prothrombin complex concentrate in the treatment of a gastrointestinal hemorrhage complicated by dabigatran.
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.
Department of Emergency Medicine, St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07503 USA.
Terrance R
TR
McGovern
Department of Emergency Medicine, St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07503 USA.
Justin J
JJ
McNamee
Department of Pharmacy, St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07503 USA.
Christopher
C
Malabanan
Department of Pharmacy, St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07503 USA.
Mohamed A
MA
Fouad
Department of Emergency Medicine, St. Joseph's Regional Medical Center, 703 Main Street, Paterson, NJ 07503 USA.
Nilesh
N
Patel
Dabigatran; Emergency medicine; Prothrombin complex concentrate; Reversal; Target-specific oral anticoagulants