Activated prothrombin complex concentrate for reversal of oral factor Xa inhibitors at a level 1 trauma center

Abstract

Direct oral anticoagulants (DOACs) are associated with fewer bleeding complications compared to warfarin (Coumadin®, Manati, Puerto Rico), specifically intracranial hemorrhage (ICH), however reversal in the setting of a life-threatening bleed may be required [1,2]. Treatment options for factor Xa inhibitors include andexanet alfa (Andexxa®, San Francisco, California, United States), prothrombin complex concentrate (PCC), and activated PCC (aPCC). These medications are recommended by supporting guidelines for treatment of oral factor Xa inhibitor-related acute major bleeding events, including ICH [3,4].