vitamin-k-1 and Disseminated-Intravascular-Coagulation

To determine patient factors associated with coagulopathy, to assess variables affecting response to vitamin K1, to describe vitamin K1-associated adverse reactions, and to survey Canadian tertiary care hospitals about vitamin K1 practice patterns in their intensive care units (ICUs).. Retrospective chart audit and prospective survey.. Medical-surgical ICU with a 23-bed complement in a tertiary care, university-affiliated hospital, and 47 Canadian tertiary care hospitals.. Forty-eight critically ill patients with nonconsumptive coagulopathies.. Intravenous vitamin K1 utilization over 4 months.. The only independent risk factor for elevated baseline international normalized ratios (INRs) was Acute Physiologic and Chronic Health Evaluation (APACHE) II score (r2 = 0.51, p<0.05). The INR values decreased after two doses of vitamin K1 10 mg for patients grouped as a whole (2.14 +/- 0.96 to 1.61 +/- 0.62, p<0.0001) and when patients were stratified according to APACHE II scores below 23 (1.83 +/- 0.44 to 1.34 +/- 0.18, p<0.05). The INRs were not significantly reduced for patients with APACHE II scores of 23 or greater (2.44 +/- 1.23 to 1.82 +/- 0.66). No variables were associated with response, and adverse events were not observed. Of 47 Canadian tertiary care hospitals surveyed, 27 (55%) responded. Twenty-four (89%) indicated that vitamin K1 was administered intravenously, and no adverse events resembling anaphylaxis were reported.. Administration of two doses of intravenous vitamin K1 10 mg was associated with reversal of coagulopathies, but variable responses may be expected for patients with high APACHE II scores. Randomized, placebo-controlled studies are necessary to confirm the effectiveness of vitamin K1.

Topics: Adult; Aged; Antifibrinolytic Agents; APACHE; Canada; Chi-Square Distribution; Data Collection; Disseminated Intravascular Coagulation; Female; Humans; International Normalized Ratio; Linear Models; Male; Middle Aged; Partial Thromboplastin Time; Prospective Studies; Retrospective Studies; Statistics, Nonparametric; Vitamin K 1

Every wound healing of a vascular lesion requires optimum values in an intact coagulation system. The high rate of secondary haemorrhages in subarachnoid haemorrhages induced us to carry out checks of the behaviour of various coagulation parameters. Increases in fibrinogen and reduced thromboplastin time values were the most marked changes of the haemostatic potential. Normal thromboplastin time values are reached by a vitamin K1 therapy.

Topics: Blood Coagulation Factors; Blood Coagulation Tests; Disseminated Intravascular Coagulation; Humans; Intracranial Aneurysm; Partial Thromboplastin Time; Recurrence; Subarachnoid Hemorrhage; Vitamin K 1

The high incidence of consumption coagulopathy in active liver cirrhosis prompted us to introduce low-dosage heparin therapy (LDHT) in the management of this condition. An investigation was carried out on 109 patients with clinical and biochemical evidence of progressive liver cirrhosis, which was designed to evaluate whether in addition to basic LDHT, the administration of either vitamin K1, human fibrinogen or partial prothrombin complex (Prothromplex 500) enhanced the results obtained with LDHT alone. The normotest, PTT, thrombin coagulase activity, fibrinogen and platelet count were determined at regular intervals. A significant increase in fibrinogen and platelet count was obtained within 14 days of LDHT in about 75% of the patients and the consumption coagulopathy was halted. Additional treatment with vitamin K1 did not bring about any further increase in the prothrombin complex. Substitution therapy with factors II, IX, X and fibrinogen combined with LDHT brought the expected results. The results reported in the literature and the aims of, and indications for LDHT are discussed.

Topics: Blood Coagulation Factors; Disseminated Intravascular Coagulation; Heparin; Humans; Liver Cirrhosis; Vitamin K 1

Topics: Birth Weight; Blood Coagulation; Blood Coagulation Tests; Blood Transfusion; Calcium; Disseminated Intravascular Coagulation; Humans; Infant, Newborn; Infant, Premature; Respiratory Distress Syndrome, Newborn; Vitamin K 1

Topics: Acute Disease; Alanine Transaminase; Aspartate Aminotransferases; Bilirubin; Blood Cell Count; Blood Coagulation Factors; Blood Coagulation Tests; Blood Platelets; Disseminated Intravascular Coagulation; Factor IX; Factor V; Factor VII; Factor X; Factor XIII; Female; Fibrinogen; Heparin; Humans; Liver Cirrhosis; Male; Methods; Prothrombin; Serum Globulins; Solubility; Vitamin K 1