Background Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence. This study aims to evaluate the efficacy and safety of vitamin K in the correction of international normalized ratio (INR) elevation secondary to liver disease in critically ill patients. Method A retrospective study of critically ill patients with coagulopathy secondary to liver disease. The primary outcome was to evaluate the association between vitamin K administration and the incidence of new bleeding events in critically ill patients with INR elevation; other outcomes were considered secondary. Patients were categorized into two groups based on vitamin K administration to correct INR elevation. The propensity score was generated based on disease severity scores and the use of pharmacological DVT prophylaxis. Results A total of 98 patients were included in the study. Forty-seven patients (48%) received vitamin K during the study period. The odds of the new bleeding event was not statistically different between groups (OR 2.4, 95% CI 0.28-21.67, P = .42). Delta of INR reduction was observed with a median of 0.63 when the first dose is given ( P-value: <.0001). However the INR reduction with other subsequent doses of vitamin K was not statistically significant. Conclusion The administration of vitamin K for INR correction in critically ill patients with coagulopathy secondary to liver disease was not associated with a lower odds of new bleeding events. Further studies are needed to assess the value of vitamin K administration in critically ill patients with liver diseases related coagulopathy.

Little is known about probiotic consumption or beliefs, in spite of its enhanced availability. Therefore, the aim of this study was to assess the knowledge, awareness, and attitudes of Saudi publics towards the oral benefits of probiotics. The web-based cross-sectional survey was conducted among 600 Saudi individuals through a questionnaire which was randomly distributed through online social media. Each of them was asked to complete a questionnaire including socio-demographic data and took a probiotic knowledge test. Probiotic knowledge was significantly linked with marital status, gender and those who are working in the health field, Majority of them were females (87.1%) being more knowledgeable than males (79.9%). The highest percentages of participants who heard about beneficial bacteria were those who are in the age group 36-45 years old at 87.3%, highly educated at 87.5%, postgraduates at 89.2%, married at 88.9%, and those who are working in the health field at 94.4%. Although beneficial, lack of sufficient knowledge concerning probiotics restricted its usage among few respondents. There is a need for further education and promotion of the general public in regards to the definition, oral benefits, sources and usage of probiotics.

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Background: Hepatic diseases have been associated with an increased risk of coagulopathy and increased odds of secondary thrombosis and bleeding. Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence.Objective: To evaluate the efficacy as well as safety of vitamin K in correction of international normalized ratio (INR) elevation secondary to liver disease in critically ill patients.Setting: Tertiary teaching hospital in Saudi Arabia.Method: A retrospective case-control study of adult ICU patients with coagulopathy secondary to liver disease. A total of 98 patients were included in the study. Patients were divided into two groups based on vitamin K administration to correct INR elevation. differences. The propensity score was generated based on disease severity scores to adjust group.Main outcomes: The primary outcome was to evaluate the association between vitamin K administration and the incidence of new bleeding events in critically ill patients with INR elevation secondary to liver disease. Secondary outcomes were to evaluate the incidence of a new thrombotic event and the degree of INR correction with vitamin K. Results: Forty-seven patients (48%) received vitamin K during the study period. The incidence of the new bleeding event was not statistically different between groups (OR 2.4, 95% CI 0.28-21.67, P=0.42). Delta of INR reduction was observed with a median of 0.63 when the first dose is given (p-value: <.0001). However, other subsequent doses of vitamin K were not statistically significant.Conclusion: Using vitamin K for INR correction in critically ill patients with coagulopathy secondary to liver disease was not associated with a lower incidence of new bleeding events. Vitamin K was efficient in reducing INR level at the first dose, other subsequent doses were not.Impacts on practice: 1. Routine use of vitamin K to correct PT/INR in critically ill patients with liver disease may need be re-evaluated.2. If the initial dose of vitamin K does not reverse INR elevation, subsequent doses may not have any effect.3. Using vitamin K to correct INR was not associated with a lower incidence of new bleeding events nor RBCs/Platelets transfusion than patients who did not receive it.

Background Hepatic diseases have been associated with an increased risk of coagulopathy and increased odds of secondary thrombosis and bleeding. Using vitamin K for correction of coagulopathy in critically ill patients is controversial with limited evidence. Objective To evaluate the efficacy as well as safety of vitamin K in correction of international normalized ratio (INR) elevation secondary to liver disease in critically ill patients. Setting Tertiary teaching hospital in Saudi Arabia. Method A retrospective case-control study of adult ICU patients with coagulopathy secondary to liver disease. A total of 98 patients were included in the study. Patients were divided into two groups based on vitamin K administration to correct INR elevation. differences. The propensity score was generated based on disease severity scores to adjust group. Main outcomes The primary outcome was to evaluate the association between vitamin K administration and the incidence of new bleeding events in critically ill patients with INR elevation secondary to liver disease. Secondary outcomes were to evaluate the incidence of a new thrombotic event and the degree of INR correction with vitamin K. Results Forty-seven patients (48%) received vitamin K during the study period. The incidence of the new bleeding event was not statistically different between groups (OR 2.4, 95% CI 0.28-21.67, P=0.42). Delta of INR reduction was observed with a median of 0.63 when the first dose is given (p-value: <.0001). However, other subsequent doses of vitamin K were not statistically significant. Conclusion Using vitamin K for INR correction in critically ill patients with coagulopathy secondary to liver disease was not associated with a lower incidence of new bleeding events. Vitamin K was efficient in reducing INR level at the first dose, other subsequent doses were not.Impacts on practice: Routine use of vitamin K to correct PT/INR in critically ill patients with liver disease may need be re-evaluated.If the initial dose of vitamin K does not reverse INR elevation, subsequent doses may not have any effect.Using vitamin K to correct INR was not associated with a lower incidence of new bleeding events nor RBCs/Platelets transfusion than patients who did not receive it.