A 48-year-old man on ICU with acute liver failure has a markedly elevated INR (6.5) but is not bleeding. Should FFP be administered to correct the INR...

Question

A 48-year-old man on ICU with acute liver failure has a markedly elevated INR (6.5) but is not bleeding. Should FFP be administered to correct the INR?

Accepted Answer

No - the INR in acute liver failure does not accurately reflect bleeding risk because both procoagulant AND anticoagulant factors are reduced; FFP obscures the INR trend (which is used for prognostication, e.g. King's College Criteria) and should only be given for active bleeding or before invasive procedures

Answer

Yes - FFP should be given routinely to normalise the INR in all patients with liver failure

Answer

Yes - FFP prevents all bleeding complications

Answer

No - because FFP is always contraindicated in liver failure

Answer

Platelets should be given instead of FFP

uk-fficm MCQ (SBA): Coagulopathy of Liver Failure

A 48-year-old man on ICU with acute liver failure has a markedly elevated INR (6.5) but is not bleeding. Should FFP be administered to correct the INR?