Hemorrhagic stroke: Difference between revisions

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==AHA Guidlines==
#Keep MAP <130 during acute phase
#Keep MAP <130 during acute phase
#When patient is anticoagulated on warfarin with INR > 2.0 should consider reversal with following:
#If on coumadin with INR >2 consider reversal:
##Vitamin K 10mg IV (small risk of anaphylaxis, takes up to 6 hours to work)
##Vitamin K 10mg IV gtt over 10min
#FFP (generally need up to 6 units to bring INR to 1.2; careful about volume overload in the elderly)
###Small risk of anaphylaxis
#Prothrombin Complex Concentrate (25-50mg/kg IV)
###Takes 6-12hr to work
##very expensive with limited data but trends are moving towards using this in life threatening bleeding.  can decrease hematoma expansion.
##FFP
#Desmopressin: can increase activity of platelets via vWF
###Usually need up to 6 units to bring INR to 1.2
###Be careful about volume overload in elderly
###Takes hours to work
##Prothrombin complex concentrate (25-50mg/kg IV)
###Fast-acting but expensive
#Desmopressin
##Can increase activity of platelets via vWF


==Source==
==Source==

Revision as of 04:42, 20 May 2011

  1. Keep MAP <130 during acute phase
  2. If on coumadin with INR >2 consider reversal:
    1. Vitamin K 10mg IV gtt over 10min
      1. Small risk of anaphylaxis
      2. Takes 6-12hr to work
    2. FFP
      1. Usually need up to 6 units to bring INR to 1.2
      2. Be careful about volume overload in elderly
      3. Takes hours to work
    3. Prothrombin complex concentrate (25-50mg/kg IV)
      1. Fast-acting but expensive
  3. Desmopressin
    1. Can increase activity of platelets via vWF

Source

Arabinda Pani, MD

2/20/2010

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