ワーファリン内服中に発症した頭蓋内出血性病変への対応  [in Japanese] How to Manage the Patients Receiving the Anticoagulant Associated with Intracranial Hemorrhage  [in Japanese]

Patients receiving anticoagulants occasionally suffer from intracranial hemorrhage. Initially, it is important to control the coagulation time for such patients, because of the possible need for emergency surgery. Previously, vitamin K and FFP (fresh frozen plasma) were administered to such patients; however, it took 3 to 6 hours to normalize the PT-INR (Prothrombin Time, International Normalized Ratio), and thus the bleeding could increase and the patients' condition might then become critical. To correct the coagulation time quickly and evacuate the hematoma as soon as possible, ninth factor complex (PPSB-HT) was administered to 5 patients who had taken Warfarin and suffered from intracranial hemorrhage. In all patients, the PT-INR quickly normalized within 10 to 20 minutes, and they were thereafter successfully treated surgically. The administration of PPSB-HT is critical to correct the coagulation time in patients taking Warfarin and requiring emergency surgery.