Page 1 of 1: Indications for FFP

Nicki · Credits: 2463 My Scrapbook My Reading List 7 Books

Reversal of warfarin
TTP
Multiple factor deficiencies- if it is a single factor specific factor should be given
DIC

dr_amh10 · Credits: 1672 My Scrapbook

The college want us to still use FFP in the reversal of warfarin overdose leading to GI bleed. This is in fact wrong. The BHS guidelines state that we should use PCC (Beriplex), and we do use this in my hospital. Hope this helps.

AMH.

Nicki · Credits: 2463 My Scrapbook My Reading List 7 Books

Hmmm.... important change...not publicised I guess due to higher cost involved
British Society for Haematology
Guidelines on oral anticoagulation (warfarin): third edition- 2005
updat
"MANAGING BLEEDING AND EXCESSIVE ANTICOAGULATION
Reversal of anticoagulation with vitamin K is achieved more rapidly with intravenous
administration than oral administration (Watson, et al 2001). In the original guideline
an option of 5mg of vitamin K orally or intravenously was recommended for patients
with major bleeding, in addition to factor replacement therapy with either a factor
concentrate or fresh frozen plasma (FFP). We now consider that in patients with
major bleeding reversal with intravenous vitamin K is preferable. A dose of either
5mg or 10mg is recommended. Complete and rapid reversal of overanticoagulation is
more readily achieved with a factor concentrate than with FFP (Evans, et al 2001,
Makris, et al 1997). Intravenous vitamin K should be given if reversal is to be
sustained (Yasaka, et al 2002). In a non-randomised observational study the
likelihood of enlargement of intracerebral haematoma was less when the INR was less
than 2.0 at the time of the bleed, or was reduced to less than 2.0 within 24 hours of
bleeding. Reversal with a factor concentrate was associated with a lower incidence of
haematoma enlargement as compared with reversal with FFP (Yasaka, et al 2003)."

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