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Am J Surg. 2009 Jun;197(6):785-90. doi: 10.1016/j.amjsurg.2008.04.003. Epub 2008 Aug 22.

A promising new alternative for the rapid reversal of warfarin coagulopathy in traumatic intracranial hemorrhage.

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  • 1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.



Internationally, Factor IX complex (FIX complex) has been used to correct warfarin-induced coagulopathy. We present our experience with 28 patients using FIX complex.


A retrospective chart review was conducted between November 2002 and July 2006 on patients with warfarin-induced coagulopathy. We recorded the dose and timing of FIX complex, serial international normalized ratios (INRs), early adverse events, and patient outcome.


Twenty-eight patients met criteria. The mean INR on admission was 5.1, and after FIX complex infusion was reduced significantly to 1.9 (P = .008). Eleven patients had a repeat INR drawn within 30 minutes after FIX complex infusion. The mean time to correction was 13.5 minutes. There were no early thrombotic events or allergic reactions.


FIX complex results in an immediate reversal of coagulopathy within 15 minutes after administration. Its use should be considered as an alternative treatment to fresh-frozen plasma and recombinant Factor VIIa. Prospective randomized trials are needed to confirm these findings.

[PubMed - indexed for MEDLINE]
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