Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_788499DD20BB
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants.
Journal
Critical Care
Author(s)
Faraoni D., Levy J.H., Albaladejo P., Samama C.M.
Working group(s)
Groupe d'Intérêt en Hémostase Périopératoire
Contributor(s)
Albaladejo P., Jebara S., Steib A., Godier A., Pernod G., Belisle S., Blais N., Bonhomme F., Borel-Derlon A., Borg JY., Bosson JL., Collet JP., De Maistre E., De Moerloose P., Fontana P., Gruel Y., Guay J., Huet Y., Ickx B., Jude B., Lasne D., Longrois D., Hardy JF., Marret E., Mismetti P., Motte S., Nathan N., Rosencher N., Samama CM., Jesel-Morel L., Schved JF., Schlumberger S., Sie P., Susen S., Van der Linden P., Vincentelli A., Zufferey P., Cohen A., Pitarch JV., Vanbelle E., Legal G., Laporte S., Lecompte TP., Ozier Y., Nguyen P., Roullet S., Faraoni D.
ISSN
1466-609X (Electronic)
ISSN-L
1364-8535
Publication state
Published
Issued date
2015
Volume
19
Pages
203
Language
english
Notes
Publication types: Journal Article
Abstract
Perioperative management of patients treated with the non-vitamin K antagonist oral anticoagulants is an ongoing challenge. Due to the lack of good clinical studies involving adequate monitoring and reversal therapies, management requires knowledge and understanding of pharmacokinetics, renal function, drug interactions, and evaluation of the surgical bleeding risk. Consideration of the benefit of reversal of anticoagulation is important and, for some low risk bleeding procedures, it may be in the patient's interest to continue anticoagulation. In case of major intra-operative bleeding in patients likely to have therapeutic or supra-therapeutic levels of anticoagulation, specific reversal agents/antidotes would be of value but are currently lacking. As a consequence, a multimodal approach should be taken which includes the administration of 25 to 50 U/kg 4-factor prothrombin complex concentrates or 30 to 50 U/kg activated prothrombin complex concentrate (FEIBA®) in some life-threatening situations. Finally, further studies are needed to clarify the ideal therapeutic intervention.
Pubmed
Web of science
Open Access
Yes
Create date
23/12/2015 14:12
Last modification date
20/08/2019 14:35
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