Preview Mode Links will not work in preview mode

Emergency Medical Minute


Jan 24, 2022

Contributor: Nick Tsipis, MD

Educational Pearls:

  • Prothrombin complex concentrate (Kcentra)  and Vitamin K are used to reverse life-threatening bleeds in patients on warfarin (Coumadin)
  • Factors II, VII, IX, and X are included in four-factor PCC
  • PCC/Kcentra dosing is 500-2000 units based on INR and patient weight
  • PROPER3 RCT was a non-inferiority trial done to evaluate standardized dosing of PCC/Kcentra versus variable dosing based on INR and weight
  • Looked at end-points to assess hemostasis, but ultimately this trial did not show non-inferiority of standardized dosing compared to variable dosing


Abdoellakhan RA, Khorsand N, Ter Avest E, et al. Fixed Versus Variable Dosing of Prothrombin Complex Concentrate for Bleeding Complications of Vitamin K Antagonists-The PROPER3 Randomized Clinical Trial. Ann Emerg Med. 2022;79(1):20-30. doi:10.1016/j.annemergmed.2021.06.016

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD


The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at and create an account. 

Donate to EMM today!