background: factor vii concentrates are used in patients with congenital or acquired factor vii deficiency or treatment of hemophilia patients with inhibitors. in this research, immunoaffinity chromatography was used to purify factor vii from prothrombin complex (prothrombin-proconvertin-stuart factor-antihemophilic factor b or ppsb) which contains coagulation factors ii, vii, ix and x. the aim...

Patients receiving vitamin K antagonists (VKAs) are at increased risk of bleeding. Intracranial hemorrhage (ICH) is a major cause of morbidity and mortality in this population, and is a particular concern among Japanese clinicians, given reports of an elevated risk of this bleeding type in patients of Asian ethnicity. Patients with VKA-associated ICH require rapid international normalized ratio...

The Questions: (1) Should the patient receive vitamin K and fresh-frozen plasma on evaluation in the emergency department to reverse international normalized ratio? (2) If so, what is the appropriate targeted international normalized ratio level? (3) Should other hemostatic agents such as prothrombin complex concentrates or NovoSeven be used instead of (or in combination with) fresh-frozen plasma?