Prothrombin complex concentrate for the management of severe traumatic bleeding in a patient anticoagulated with apixaban.

WHAT IS KNOWN AND OBJECTIVE: Given the data for four factor prothrombin complex concentrate (PCC) for vitamin K antagonist (VKA) reversal, there is great interest to determine whether PCC can improve patient outcomes in patients with bleeds associated with the newer oral anticoagulants (NOAC).

CASE DESCRIPTION: We describe the case of an adult trauma patient anticoagulated with apixaban, presenting with a severe life-threatening bleed. PCC was administered at the maximum dose when the patient was determined to be refractory to supportive care with blood products.

WHAT IS NEW AND CONCLUSION: Despite maximal treatment efforts, haemostasis was not achieved and the patient expired.