How do I use KCentra for reversal of anticoagulation?
KCentra aka PCC4 (prothrombin complex concentrate 4)
Contains Factors 2, 7, 9, 10, Proteins C & S, antithrombin III, human albumin, and heparin (to stop early activation of factors)
PCC-3 doesn't have factor 7, Protein C, or Protein S
Dosing for Warfarin Reversal
You don't have to memorize this! It's in our order set! And also on Kcentra.com
INR 2-4 = 25 units/kg
INR 4-6 = 35 units/kg
INR >6 = 50 units/kg
Life threatening bleed and don't have the INR yet? 1500 unit flat dose
MUST GET INR to assess the need for supplemental dosing.
For a 75kg patient, 1500 units is only 20 units/kg, so regardless of INR, the patient will likely require more KCentra.
Get repeat INR 30-60 minutes after dose of KCentra
If elevated, may require additional doses
Monitor for signs and symptoms of thromboembolic events
Dosing for NOAC Reversal
Patients with heparin induced thrombocytopenia (HIT)
Patients who do not want blood products
Also has the same risks as giving blood products