Intraosseous administration of 4-factor prothrombin complex concentrate

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We describe a case of a 69-year-old female receiving oral apixaban that was successfully administered 4F-PCC using intraosseous access prior to emergent surgery to obtain haemostasis intraoperatively” Ratliff et al (2019).

Abstract:

WHAT IS KNOWN AND OBJECTIVE: The 4-factor prothrombin complex concentrate (4F-PCC) may be used to emergently achieve haemostasis in patients on anticoagulation prior to surgery. Limited data exist using the intraosseous route of administration of 4F-PCC in patients taking factor Xa inhibitors.

CASE DESCRIPTION: We describe a case of a 69-year-old female receiving oral apixaban that was successfully administered 4F-PCC using intraosseous access prior to emergent surgery to obtain haemostasis intraoperatively.

WHAT IS NEW AND CONCLUSION: Intraosseous access may be a viable route of administration for 4F-PCC in patients receiving factor Xa inhibitors to achieve haemostasis when necessary.

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Reference:

Ratliff, P., Nutley, K., Schroeder, W. and Cottingham, L. (2019) Intraosseous administration of 4-factor prothrombin complex concentrate prior to emergent surgery after receiving apixaban. Journal of Clinical Pharmacy and Therapeutics. December 5th. doi: 10.1111/jcpt.13094. .

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