ABSTRACT
A 66-year-old man with a metallic valve and under treatment with acenocoumarol developed hypovolemic shock after rupture of a splenic artery pseudoaneurysm. We managed to reverse anticoagulation within 60 minutes by administering 20 mg of vitamin K and 4.8 mg of activated recombinant factor VII. No thromboembolic adverse events were observed. We discuss the pharmacologic effects of coumarin derivatives and their antagonists, as well as the use of activated factor VII in the reversal of anticoagulation by these drugs.
Subject(s)
Acenocoumarol/adverse effects , Aneurysm, False/complications , Anticoagulants/adverse effects , Factor VIIa/therapeutic use , Hemoperitoneum/drug therapy , Splenic Artery/pathology , Vitamin K 1/therapeutic use , Acenocoumarol/antagonists & inhibitors , Acenocoumarol/therapeutic use , Aged , Anticoagulants/therapeutic use , Combined Modality Therapy , Crystalloid Solutions , Drug Therapy, Combination , Embolization, Therapeutic , Erythrocyte Transfusion , Factor VIIa/administration & dosage , Heart Valve Prosthesis , Hemoperitoneum/chemically induced , Hemoperitoneum/etiology , Hemoperitoneum/therapy , Humans , Isotonic Solutions/therapeutic use , Male , Recombinant Proteins/administration & dosage , Recombinant Proteins/therapeutic use , Rupture, Spontaneous , Vitamin K 1/administration & dosageABSTRACT
The VA DHCP, hospital computer program represents an integral solution to the complex clinical and administrative functions of any hospital world wide. Developed by the Department of Veterans Administration, it has until lately run exclusively in mainframe platforms. The recent implementation in PCs opens the opportunity for use in Latinamerica. Detailed description of the strategy for Spanish, local implementation in Colombia is made.
