A 60-year-old woman on ICU is receiving IV unfractionated heparin for a submassive PE. Her APTT ratio is 2.2 (target 1.5-2.5). She develops massive up...

Question

A 60-year-old woman on ICU is receiving IV unfractionated heparin for a submassive PE. Her APTT ratio is 2.2 (target 1.5-2.5). She develops massive upper GI bleeding. Heparin is stopped. Twenty minutes later, APTT ratio remains 2.0. She continues to bleed. What is the most appropriate reversal?

Accepted Answer

Administer IV protamine sulphate 1 mg per 100 units of heparin given in the preceding hour

Answer

Wait for heparin to wear off - it has a short half-life

Answer

Administer IV vitamin K 10 mg

Answer

Administer recombinant Factor VIIa

Answer

Perform plasma exchange

uk-fficm MCQ (SBA): Heparin Reversal

A 60-year-old woman on ICU is receiving IV unfractionated heparin for a submassive PE. Her APTT ratio is 2.2 (target 1.5-2.5). She develops massive upper GI bleeding. Heparin is stopped. Twenty minutes later, APTT ratio remains 2.0. She continues to bleed. What is the most appropriate reversal?