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Upper gastrointestinal bleed

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If your patient's prothrombin time is prolonged (or INR raised)  give a concentrate of factors II, VII, IX, and X at a dose of 50 units of factor IX per kg body weight c

Why?

  • It is better than fresh frozen plasma at lowering INR < 2.0 within 15 minutes c

Factor concentrate reverses INR faster than fresh frozen plasma

Patient Treatment Comparison Outcome CER RRR
(95% CI)		 NNT
(95% CI)
urgent reversal of INR required c factor concentrate fresh frozen plasma INR ≤ 2.0
at 15 minutes 		58% 66%
(2% to 168%) 		3
(1 to 10)

Expiry date: July 2003
Levels of Evidence used in grading these guides

Author   A   Townsend , CM   Ball
Reviewer   L   Friedman
CAT Writers   A   Townsend , CM   Ball , CJ   Wotton