Template:ICH Coagulopathy Guidelines
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AHA ICH Coagulopathy Guidelines[1]
- "Patients with a severe coagulation factor deficiency or severe thrombocytopenia should receive appropriate factor replacement therapy or platelets, respectively (Class I; Level of Evidence: C)"
- ICH and elevated INR is elevated due to warfarin should have warfarin held and receive replacement of vitamin K–dependent factors and intravenous vitamin K (Class I; Level of Evidence: C).
- Prothrombin Complex Concetrates (PCCs) have not shown improved outcome compared with FFP but may have fewer complications compared with FFP and are reasonable to consider as an alternative to FFP (Class IIa; Level of Evidence: B).
- rFVIIa does not replace all clotting factors, and although the INR may be lowered it may not affect clotting proportionately. rFVIIa is not routinely recommended as a sole agent for reversal in ICH (Class III; Level of Evidence: C).
- "The usefulness of platelet transfusions in ICH patients with a history of antiplatelet use is unclear and is considered investigational (Class IIb; Level of Evidence: B)."