Is it time to stop giving vitamin K in nonbleeding patients with an elevated PT INR testing? One study suggests so. It's no better than placebo AND it makes reinitiating anticoagulation quite difficult in the post vitamin K period of time. I see this too many times. Just stop it.
Thanks. This is good to know. Had not see the study yet.
ReplyDeleteThanks. This is good to know. Had not see the study yet.
ReplyDeleteThat study looked at 1.25mg vitamin K, and apparently found no difference with placebo. What about 2.5mg doses, which is still part of the Vitamin K dose tange recommended by ACCP for these patients?
ReplyDeleteRegardless, I think we're getting closer to dumping Vitamin K for nonbleeding patients. Just need that data to keep pouring in.
a-MEN brutha!
ReplyDeleteSuch a pain in the ass.
Good to know. Do you think you might start posting "clinical pearls" on your blog? Practical, common-place medical stuff that comes with the experience you have? I'm an intern and follow your blog regularly. To similar readers, it would be a nice read.
ReplyDeleteThis study was in Annals and from McMaster (it could only have been done there - would 337 patients in the US consented to placebo for INR's or 10?). These folks have looked at dosing forms (IV, SQ and po - po is best) and dose (1.25mg is plenty) in prior studies. I have been reccomending not giving Vit K for years based on observational data (ie my own clinical experience), and now have some real data to back it up. Also - everyone please stop using IVC filters. They INCREASE thrombosis rate! (Decousis NEJM 1997).
ReplyDeletestudy is underpowered to detect differences in major bleeding though...
ReplyDelete