Kcentra 2000 Units: Infusion Volume and Duration
For a 2000-unit dose of Kcentra, the infusion volume is 100 mL and the recommended administration duration is approximately 8–17 minutes at the standard rate, though faster administration has been used safely in life-threatening emergencies.
Standard Infusion Parameters
The manufacturer recommends administering Kcentra at a maximum rate of 0.12 mL/kg/min (approximately 3 units/kg/min) up to an absolute maximum rate of 8.4 mL/min (approximately 210 units/min). 1
A 2000-unit dose of Kcentra is supplied in a 100 mL total volume after reconstitution. 2
At the maximum recommended rate of 8.4 mL/min, a 100 mL infusion would take approximately 12 minutes to complete. 1
At the lower end of the recommended range (0.12 mL/kg/min for a 70 kg patient = 8.4 mL/min), the duration remains approximately 12 minutes; for smaller patients the rate would be proportionally slower, extending to 15–17 minutes for a 50 kg patient. 1
Rapid Administration in Emergencies
In life-threatening bleeding with cardiopulmonary arrest, Kcentra 2000 units has been successfully administered as an IV push over approximately 20 seconds without immediate thrombotic complications. 1
European consensus guidelines support an initial bolus of 25 IU/kg for massively bleeding patients with coagulopathy, which can be given more rapidly than standard rates when clinically indicated. 3
Small studies have assessed infusion rates exceeding manufacturer recommendations with few reported thromboembolic events, though the primary concern with rapid administration remains increased thrombotic risk. 1
Administration Technique
Kcentra should be administered through a dedicated IV line to avoid mixing with other medications, as incomplete mixing of drugs in IV infusions can result in dangerous concentration variability. 4
The infusion should be given via slow IV infusion over 15–30 minutes in most clinical scenarios to minimize adverse reactions, similar to vitamin K administration protocols. 5
For patients requiring urgent reversal but not in cardiac arrest, a practical approach is to infuse the 100 mL volume over 10–15 minutes, which exceeds the minimum safe rate while providing rapid factor replacement. 3
Critical Monitoring Considerations
Recheck INR 15–60 minutes after PCC administration to assess the degree of correction. 6
Vitamin K 5–10 mg IV must be co-administered with Kcentra because factor VII has a half-life of only 4–6 hours, requiring vitamin K to stimulate endogenous factor production for sustained reversal. 2, 6
PCC use increases thrombotic risk during the recovery period, and thromboprophylaxis must be considered as early as possible after bleeding control is achieved. 6
Common Pitfalls to Avoid
Do not dilute Kcentra further after reconstitution; the 100 mL volume is the final concentration for administration. 2
Avoid administering through the same line as other medications without flushing, as drug mixing can create dangerous concentration gradients. 4
Never rely on Kcentra alone without vitamin K co-administration, as rebound coagulopathy will occur when the short-acting factor VII is depleted. 2, 6
In patients with high thrombotic risk (e.g., recent cardiac surgery), consider using a half-dose bolus (12.5 IU/kg) initially rather than the full 25 IU/kg dose. 3