Weitz et al., 2012 [32]
|
Discontinue treatment until bleeding resolves
|
Sequential treatment:
|
aPCC (50 IU/kg)
|
(1) PCC (40 IU/kg)
|
If unavailable, give PCC (40 IU/kg) or rFVIIa (90 μg/kg)
|
(2) aPCC (50 IU/kg)
|
(3) rFVIIa (90 μg/kg)
|
(4) Haemodialysis for 6–8 h or charcoal filtration
|
Faraoni et al., 2015 [29]
|
No recommendation given
|
No recommendation given
|
(1) Monitor blood loss and perform coagulation assays
|
(2) Standard resuscitation with fluid therapy, tranexamic acid (1 g), RBCs and massive transfusion protocola
|
(3) Four-factor PCC (25–50 IU/kg), aPCC (FEIBA; 30–50 IU/kg)
|
EHRA guidelines [30]
|
Maintain diuresis
|
Same recommendation as for mild bleeding
|
PCC 50 U/kg (additional 25 U/kg if clinically needed)aPCC 50 U/kg (maximum 200 U/kg/day)rFVIIa (90 μg/kg)Idarucizumab 5 g intravenously
|
Local haemostatic measures
|
Fluid replacement
| |
RBC substitution if necessary
|
Platelet substitution if necessary
| |
FFP as plasma expander (not as reversal agent)
| |
Consider tranexamic acid or desmopressin
|
Consider dialysis
|
ESA guidelines [28]
|
No recommendation given
|
No recommendation given
|
PCC, aPCC or rFVIIa may be used as non-specific antagonists
|