title: Prothrombin complex concentrate for the management of severe traumatic bleeding in a patient anticoagulated with apixaban.
abstract: OBJECTIVE
  Given the data for four factor prothrombin complex concentrate (PCC) for vitamin K antagonist (VKA) reversal, there is great interest to determine whether PCC can improve patient outcomes in patients with bleeds associated with the newer oral anticoagulants (NOAC).
  
  
  METHODS
  We describe the case of an adult trauma patient anticoagulated with apixaban, presenting with a severe life-threatening bleed. PCC was administered at the maximum dose when the patient was determined to be refractory to supportive care with blood products.
  
  
  CONCLUSIONS
  Despite maximal treatment efforts, haemostasis was not achieved and the patient expired.
authors.affiliation: Cardiology, Jersey Shore University Medical Center, Neptune, NJ, USA.|Ernest Mario School of Pharmacy, Rutgers University, Neptune, NJ, USA.
authors.forename: R
authors.initials: R
authors.lastname: Durie
authors.affiliation: Ernest Mario School of Pharmacy, Rutgers University, Neptune, NJ, USA.|Critical Care, Jersey Shore University Medical Center, Neptune, NJ, USA.
authors.forename: M
authors.initials: M
authors.lastname: Kohute
authors.affiliation: Jersey Shore University Medical Center, Neptune, NJ, USA.
authors.forename: C
authors.initials: C
authors.lastname: Fernandez
authors.affiliation: Jersey Shore University Medical Center, Neptune, NJ, USA.
authors.forename: M
authors.initials: M
authors.lastname: Knight
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D001779:Blood Coagulation Factors / Q000008:administration & dosage*; D006470:Hemorrhage / Q000139:chemically induced / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects*; D011728:Pyridones / Q000008:administration & dosage / Q000009:adverse effects*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D001779:Blood Coagulation Factors; D011720:Pyrazoles; D011728:Pyridones; C025667:prothrombin complex concentrates; C522181:apixaban
keywords: anticoagulants; blood coagulation factors; hemorrhage; hemostasis