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

Publication ,  Other
Faraoni, D; Levy, JH; Albaladejo, P; Samama, C-M; Groupe d’Intérêt en Hémostase Périopératoire
Published in: Crit Care
April 29, 2015

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.

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Published In

Crit Care

DOI

EISSN

1466-609X

Publication Date

April 29, 2015

Volume

19

Issue

1

Start / End Page

203

Location

England

Related Subject Headings

  • Vitamin K
  • Rivaroxaban
  • Pyridones
  • Pyrazoles
  • Perioperative Care
  • Oral Medicine
  • Medication Therapy Management
  • Humans
  • Hemorrhage
  • Factor Xa Inhibitors
 

Citation

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Faraoni, D., Levy, J. H., Albaladejo, P., Samama, C.-M., & Groupe d’Intérêt en Hémostase Périopératoire. (2015). Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants. Crit Care. England. https://doi.org/10.1186/s13054-015-0930-9
Faraoni, David, Jerrold H. Levy, Pierre Albaladejo, Charles-Marc Samama, and Groupe d’Intérêt en Hémostase Périopératoire. “Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants.Crit Care, April 29, 2015. https://doi.org/10.1186/s13054-015-0930-9.
Faraoni D, Levy JH, Albaladejo P, Samama C-M, Groupe d’Intérêt en Hémostase Périopératoire. Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants. Vol. 19, Crit Care. 2015. p. 203.
Faraoni, David, et al. “Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants.Crit Care, vol. 19, no. 1, 29 Apr. 2015, p. 203. Pubmed, doi:10.1186/s13054-015-0930-9.
Faraoni D, Levy JH, Albaladejo P, Samama C-M, Groupe d’Intérêt en Hémostase Périopératoire. Updates in the perioperative and emergency management of non-vitamin K antagonist oral anticoagulants. Crit Care. 2015. p. 203.

Published In

Crit Care

DOI

EISSN

1466-609X

Publication Date

April 29, 2015

Volume

19

Issue

1

Start / End Page

203

Location

England

Related Subject Headings

  • Vitamin K
  • Rivaroxaban
  • Pyridones
  • Pyrazoles
  • Perioperative Care
  • Oral Medicine
  • Medication Therapy Management
  • Humans
  • Hemorrhage
  • Factor Xa Inhibitors