Thrombotic complications following the administration of high-dose prothrombin complex concentrate for acute warfarin reversal

Current recommendations for dosing of PCC in the United States may lead to overcorrection and increased risk of life-threatening thromboembolic complications. [...]an individualized approach to reversal balancing both the urgency of the situation and thromboembolic risk of the patient should be taken into consideration before dose selection. [...]although the rate of thromboembolism with 4-factor PCC in clinical trials appeared similar to that of plasma, in the administration of PCC to more than 140 patients at our institution, thromboembolism within 72hours has occurred at a disproportionately higher rate in patients receiving higher doses of PCC (14.8% [4/27] for 35-50 U/kg vs. 0% [0/114] for 15-25 U/kg).