{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T12:55:18Z","timestamp":1776344118174,"version":"3.51.2"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Management of coagulopathy in chronic liver disease (CLD) poses a challenge for critical care physicians. Prothrombinex\u00ae\u2010VF is a low\u2010volume product with rapid onset of action. Evidence for its efficacy and safety in CLD is limited and cases of acute intravascular coagulation and fibrinolysis (AICF) and\/or disseminated intravascular coagulation (DIC) have been reported. Our objective was to evaluate the role of Prothrombinex\u00ae\u2010VF in reversal of coagulopathy and the incidence AICF\/DIC, thromboembolic events and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective, multi\u2010centre study of Prothrombinex\u00ae\u2010VF use in CLD across 11 hospitals over a 2\u2010year period, excluding those on therapeutic anticoagulation. Patients were subclassified into acute on chronic liver failure (ACLF), acute decompensation (ADC) and compensated cirrhosis. Reversal of coagulopathy was defined as international normalised ratio (INR) &lt;1.5\u00d7 upper limit normal (ULN), prothrombin time &lt;1.5\u00d7 ULN, activated partial thromboplastin time &lt;1.5\u00d7 ULN and fibrinogen &gt;1\u00a0g\/L. Markers of AICF\/DIC were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty CLD patients were included, and the median model for end\u2010stage liver disease score was 23.5. Acute bleeding was the most common indication for Prothrombinex\u00ae\u2010VF (60%). All had baseline coagulopathy and the majority did not achieve reversal. Key indicators of AICF\/DIC were mainly observed in those with ACLF; bleeding from mucosa or lines (53%), worsening hypofibrinogenaemia (60%), worsening thrombocytopaenia (60%). The ADC and compensated cirrhosis groups were relatively unaffected. Incidence of venous thromboembolism was 6%. Overall mortality was 43% and 70% in ACLF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prothrombinex\u00ae\u2010VF did not lead to meaningful reversal of coagulopathy and should be used with caution in CLD. Patients with ACLF were more likely to develop AICF\/DIC following Prothrombinex\u00ae\u2010VF, although the association is uncertain. Further studies are needed to evaluate the safety and efficacy of Prothrombinex\u00ae\u2010VF use in CLD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14058","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T09:13:50Z","timestamp":1661159630000},"page":"89-96","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prothrombinex\u00ae\u2010<scp>VF<\/scp> in chronic liver disease: Friend or foe?"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4275-2588","authenticated-orcid":false,"given":"Akmez","family":"Latona","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Ipswich Hospital  Ipswich Queensland Australia"},{"name":"Department of Emergency Medicine Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Department of Emergency Medicine St Vincent's Private Hospital  Toowoomba Queensland Australia"},{"name":"The University of Queensland  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Haematology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Griffith University  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurelia","family":"Connelly","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Stuart","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Wood","sequence":"additional","affiliation":[{"name":"Department of Haematology Princess Alexandra Hospital  Brisbane Queensland Australia"},{"name":"Department of Haematology Calderdale and Huddersfield NHS Foundation Trust  Huddersfield England"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2021000283"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31646"},{"key":"e_1_2_9_4_1","first-page":"23","article-title":"AGA clinical practice update: coagulation in cirrhosis","volume":"157","author":"Jacqueline O'L","year":"2019","journal-title":"Gastroenterology"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1914900"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.976"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/asheducation-2015.1.243"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21732"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28628"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cld.947"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2018.7.37893"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.09.003"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13342"},{"key":"e_1_2_9_14_1","volume-title":"Prothrombin Complex Concentrate","author":"Baskaran J","year":"2021"},{"key":"e_1_2_9_15_1","volume-title":"Prothrombinex\u00ae\u2010VF","author":"CSL Behring","year":"2020"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/imj.14272"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.02801.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029616668406"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1293"},{"key":"e_1_2_9_21_1","volume-title":"ACL TOP Fibrinogen Clauss (FibC\/QFA)","author":"Solano C","year":"2016"},{"key":"e_1_2_9_22_1","volume-title":"Patient Blood Management Guidelines. 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