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Table 16-8

Correction of inherited factor deficiencies when there is not a specific factor concentrate (e.g., factor V) and when the PT or aPTT is >1.5 times mean control
Correction of acquired multifactor deficiencies with clinical evidence of bleeding or in anticipation of major surgery or an invasive procedure with PT or aPTT >1.5 times control
  • Liver dysfunction with clinical signs of bleeding
  • DIC with clinical signs of bleeding
  • Microvascular bleeding associated with massive transfusion and estimated blood loss >1 blood volume (when PT and aPTT are >1.5 times control or cannot be obtained)
  • Reversal of vitamin K antagonists (warfarin)*
  • Heparin resistance secondary to antithrombin deficiency when AT concentrate is not available
Treatment of thrombotic microangiopathies (TTP, HELLP syndrome, or HUS)
Treatment of hereditary angioedema when C1-esterase inhibitor is not available

*Prothrombin complex concentrates (II, VII, IX, X) are more effective than FFP.

aPTT = activated partial thromboplastin time; AT = antithrombin; DIC = disseminated intravascular coagulation; HELLP = hemolytic anemia, elevated liver enzymes, and low platelet count; HUS = hemolytic uremic syndrome; PT = prothrombin time; TTP = thrombotic thrombocytopenic purpura.