![]() ![]() All patients received supportive management, interventions/procedures aimed at attaining source control of bleeding when possible, and transfusion of FEIBA™ for reversal of anticoagulant effect. ![]() ![]() The last dose of DOAC was taken within 24 hours of bleeding events for all patients. A majority of patients had atrial fibrillation (n=8) and received rivaroxaban (n=5). Baseline characteristics are depicted in Table 1. Spontaneous episodes included epistaxis or gastro-intestinal bleeding. Results: Nine patients presented to hospital with life threatening bleeding episodes (post trauma: n=3 spontaneous bleeding: n=6). Secondary outcome was symptomatic control of bleeding. The primary outcome was adverse thrombotic and embolic events during follow-up. Patients received 25 – 50 units/kg of FEIBA™. Methods: A retrospective review of patients presenting with DOAC-associated (dabigatran, rivaroxaban or apixaban) life threatening bleeding to The Ottawa Hospital between January 2013 and June 2014 are included. Herein we describe management and outcomes of DOAC-associated life threatening bleeding events using an activated PCC (FEIBA™). In vivo studies, case reports and case series have shown that prothrombin complex concentrate (PCC) and activated PCC might potentially be used to control life threatening bleeding in patients with DOAC-associated bleeding episodes. Although DOACs offer advantages over the vitamin K antagonists, some hesitancy remains over their use given the lack of specific antidotes for management of life threatening bleeding events. Introduction: Direct oral anticoagulants (DOACs) are indicated for the prevention of systemic embolism in patients with atrial fibrillation and for the prevention and treatment of venous thrombosis. ![]()
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