New Guidelines on Reversal of Anticoagulants in Patients with Intracranial Hemorrhage

Appropriate use of prothrombin complex concentrate and specific reversal agents are recommended.

Sponsoring Organizations: Neurocritical Care Society (NCS) and Society of Critical Care Medicine (SCCM)

Target Audience: All critical care providers who care for patients with neurological emergencies

Background

NCS/SCCM brought together a 13-person international, multidisciplinary committee to provide guidance on managing patients with antithrombotic drug–associated intracranial hemorrhage (ICH).

Key Points

Vitamin K antagonists should be reversed. Suggested dosing is 10 mg vitamin K intravenously, to be repeated if international normalized ratio (INR) remains above 1.4 at 24 to 48 hours.
For patients with INR >1.4, administering three- or four-factor prothrombin complex concentrate (PCC) is recommended over using fresh frozen plasma.
If event oc…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar