Intravenous Vitamin K1 for the Correction of Prolonged Prothrombin Times in Non-Bleeding Critically Ill Patients: A Prospective Observational Study

S. Dahlberg*, U. Schott, E.A. Eriksson, Y. Tahirsylaj, L. Schurgers, T. Kander

*Corresponding author for this work

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Abstract

The aim of this study was to evaluate the effects of vitamin K1 on various vitamin K-dependent proteins in critically ill patients with prolonged Owren PT. We included critically ill non-bleeding adult patients without liver failure or anticoagulation treatment, with Owren PT > 1.2, who were prescribed intravenous vitamin K1. Blood was drawn at baseline and at 20-28 h after vitamin K1 administration. At both time points, we measured various vitamin K-dependent proteins and coagulation assays. ClinicalTrials.gov; Identifier: NTC3782025. In total, 52 patients were included. Intravenous vitamin K1 reduced Owren PT, Quick PT, protein induced by vitamin K absence/antagonist-II and desphospho-uncarboxylated matrix Gla protein (dp-ucMGP), but not to normal levels. Concomitantly, there were increases in thrombin generation and the activity of coagulation factors II, VII, IX and X that was only counteracted with a small increase in Protein C activity. In conclusion, the results suggest that vitamin K1 strengthens coagulation as measured by PT decrease and increases in the activity of vitamin K-dependent clotting factors and thrombin generation. The decreased dp-ucMGP, and its potential positive short- and long-term non-coagulative effects, merits further research.
Original languageEnglish
Article number2580
Number of pages12
JournalNutrients
Volume13
Issue number8
DOIs
Publication statusPublished - 1 Aug 2021

Keywords

  • prothrombin
  • vitamin K
  • Gla protein
  • PIVKA-II
  • dp-ucMGP
  • intensive care
  • INTENSIVE-CARE-UNIT
  • HEMODIALYSIS-PATIENTS
  • K DEFICIENCY
  • MORTALITY
  • PROTEIN
  • ACID

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