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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com

WORLD EMERGENCY MEDICINE SOCIETIES

Rapid IJ (aka Easy Internal Jugular Cannulation)

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viernes, 26 de julio de 2013

Reversión de los nuevos anticoagulantes

The Posion Review - August 29, 2012
"Representatives from ten organizations that focus on thrombosis and anticoagulation convened a meeting in December 2011 and collaborated to develop pragmatic guidance to help clinicians manage the reversal of these new anticoagulants [dabigatran, apixaban, rivaroxaban] until more definitive and evidence-based guidelines are available. This meeting had members of the following organizations that belong to the Thrombosis and Hemostasis Summit of North American: Hemostasis and Thrombosis Research Society; Anticoagulation Forum; American Thrombosis and Hemostasis Network; North American specialized Coagulation Laboratory Association; American Heart Association; Association of Hemophilia Clinic Directors of Canada; Foundation for Women & Girls with Blood Disorders; National Blood Clot Alliance; Thrombosis Interest Group of Canada; and National Hemophilia Foundation"
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Kaatz S et al. Am J Hematol 2012; 87: S14-S145
"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."