Guidance on the emergent reversal of oral thrombin and factor Xa inhibitors

被引：248

作者：

Kaatz, Scott ^{[1
]}

Kouides, Peter A. ^{[2
]}

Garcia, David A. ^{[3
]}

Spyropolous, Alex C. ^{[4
]}

Crowther, Mark ^{[5
]}

Douketis, Jim D. ^{[5
]}

Chan, Anthony K. C. ^{[6
]}

James, Andra ^{[7
]}

Moll, Stephan ^{[8
]}

Ortel, Thomas L. ^{[9
]}

Van Cott, Elizabeth M. ^{[10
]}

Ansell, Jack ^{[11
]}

机构：

[1] Henry Ford Hosp, Dept Med, Detroit, MI 48202 USA

[2] Mary M Gooley Hemophilia Ctr, Dept Med, New York, NY USA

[3] Univ New Mexico, Dept Med, Albuquerque, NM 87131 USA

[4] Univ Rochester, Med Ctr, Div Hematol Oncol, Rochester, NY 14642 USA

[5] McMaster Univ, Dept Med, Hamilton, ON, Canada

[6] McMaster Childrens Hosp, Div Pediat Hematol Oncol, Hamilton, ON, Canada

[7] Duke Univ, Dept Obstet & Gynecol & Med, Durham, NC USA

[8] Univ N Carolina, Sch Med, Dept Med, Chapel Hill, NC USA

[9] Duke Univ, Med Ctr, Dept Pathol & Med, Durham, NC USA

[10] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA

[11] NYU, Sch Med, Dept Med, New York, NY USA

来源：

AMERICAN JOURNAL OF HEMATOLOGY | 2012年 / 87卷

关键词：

PARTIAL THROMBOPLASTIN TIME; MONITORING UNFRACTIONATED HEPARIN; VENOUS THROMBOSIS; ANTICOAGULANT-THERAPY; INTRAVENOUS HEPARIN; PULMONARY-EMBOLISM; MAST-CELLS; THROMBOEMBOLISM; REAGENTS; RANGE;

D O I：

10.1002/ajh.23202

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The new oral anticoagulants dabigatran, rivaroxaban and apixaban have advantages over warfarin which include no need for laboratory monitoring, less drug-drug interactions and less food-drug interactions. However, there is no established antidote for patients who are bleeding or require emergent surgery and there is a paucity of evidence to guide the clinical care during these situations. Members of thrombosis and anticoagulation groups participating in the Thrombosis and Hemostasis Summit of North America formulated expert opinion guidance for reversing the anticoagulant effect of the new oral anticoagulants and suggest: routine supportive care, activated charcoal if drug ingestion was within a couple of hours, and hemodialysis if feasible for dabigatran. Also, the pros and cons of the possible use of four factor prothrombin complex concentrate are discussed. Am. J. Hematol. 87: S141-S145, 2012. (C) 2012 Wiley Periodicals, Inc.

引用

页码：S141 / S145

页数：5

共 34 条

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