Prothrombin Complex Concentrates Before LP for Patients on Vitamin K Antagonists

A small case series finds no lumbar puncture–related bleeding events in 37 patients treated with PCCs.

When emergency lumbar puncture (LP) is required for patients on vitamin K antagonists, fresh frozen plasma (FFP) is usually given to achieve temporary reversal of anticoagulation. Investigators reviewed 37 cases in which prothrombin complex concentrates (PCCs) were used instead of FFP at a tertiary hospital in Germany between 2004 and 2014.

The median international normalized ratio (INR) was 2.2 before PCC treatment and 1.3 after treatment, before LP. The target INR (≤1.5) was achieved in 33 of 37 patients (89%). All 37 patients underwent LP, and none had a hemorrhagic complication.

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Prothrombin Complex Concentrates Before LP for Patients on Vitamin K Antagonists

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Reviewing Author