Intraosseous administration of 4-factor prothrombin complex concentrate prior to emergent surgery after receiving apixaban.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: The 4-factor prothrombin complex concentrate (4F-PCC) may be used to emergently achieve haemostasis in patients on anticoagulation prior to surgery. Limited data exist using the intraosseous route of administration of 4F-PCC in patients taking factor Xa inhibitors. CASE DESCRIPTION We describe a case of a 69-year-old female receiving oral apixaban that was successfully administered 4F-PCC using intraosseous access prior to emergent surgery to obtain haemostasis intraoperatively. WHAT IS NEW AND CONCLUSION: Intraosseous access may be a viable route of administration for 4F-PCC in patients receiving factor Xa inhibitors to achieve haemostasis when necessary.