A 62-year-old woman with end-stage renal failure on regular haemodialysis is admitted to ICU with hypotension and shock. She is on long-term warfarin ...

Question

A 62-year-old woman with end-stage renal failure on regular haemodialysis is admitted to ICU with hypotension and shock. She is on long-term warfarin for metallic mitral valve replacement. Her INR is 8.5 and she has signs of retroperitoneal haemorrhage on CT. What is the optimal reversal strategy for warfarin in this patient?

Accepted Answer

IV prothrombin complex concentrate (PCC) and IV vitamin K 5 mg

Answer

IV vitamin K 5 mg alone

Answer

Fresh frozen plasma 15 mL/kg

Answer

Recombinant Factor VIIa

Answer

Withhold warfarin and wait for INR to normalise

uk-fficm MCQ (SBA): Warfarin Reversal - Mechanical Valve