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Clinical experience with oral versus intravenous vitamin K for warfarin reversal.
- Source :
-
Transfusion [Transfusion] 2013 Mar; Vol. 53 (3), pp. 491-8; quiz 490. Date of Electronic Publication: 2012 Jun 28. - Publication Year :
- 2013
-
Abstract
- Background: Reversal of warfarin with plasma accounts for a large amount of fresh-frozen plasma transfused in the United States. The use of vitamin K is an alternate strategy.<br />Study Design and Methods: Records of vitamin K prescriptions for warfarin reversal were examined and recipients identified where data were available on dosage, route of administration (oral [PO] and intravenous [IV]) and the availability of both pre- and postadministration international normalized ratio(s) (INRs).<br />Results: A total of 135 administration events were evaluated: 81 PO and 54 IV. The median (range) preadministration INRs were 5.8 (1.9-16.5) versus 5.0 (1.4-16.5; p=0.61) and the median (range) for the postadministration INRs were 2.4 (1.0-10.4) and 2.1 (1.2-8.2; p<0.01) for the PO and IV routes, respectively. The median (range) doses were 2.5(1-10) and 2.0(1-10) mg for PO and IV, respectively (p<0.01). A total of 44% of the IV vitamin K group achieved an INR of 2 or less within 12 hours versus 14% for the PO route (p<0.01). In multilinear regression the preadministration INR (r=0.14, p<0.01) and time after administration (r=-0.05, p<0.01) were independent variables influencing the postadministration INR but the dose administered (r=0.09, p=0.07) was not.<br />Conclusion: Vitamin K needs to be given IV if urgent partial correction (<12 hr) of warfarin is required. No influence of dose administered in the range 1 to 10 mg on the postadministration INR was observed.<br /> (© 2012 American Association of Blood Banks.)
- Subjects :
- Administration, Intravenous
Administration, Oral
Adult
Aged
Aged, 80 and over
Anticoagulants administration & dosage
Anticoagulants adverse effects
Anticoagulants antagonists & inhibitors
Dose-Response Relationship, Drug
Female
Humans
Male
Middle Aged
Practice Patterns, Physicians' trends
Retrospective Studies
Vitamin K adverse effects
Warfarin administration & dosage
Vitamin K administration & dosage
Warfarin adverse effects
Warfarin antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1537-2995
- Volume :
- 53
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Transfusion
- Publication Type :
- Academic Journal
- Accession number :
- 22738309
- Full Text :
- https://doi.org/10.1111/j.1537-2995.2012.03755.x