Management of direct oral anticoagulants in patients undergoing elective surgeries and invasive procedures: Updated guidelines from the French Working Group on Perioperative Hemostasis (GIHP) - September 2015

被引:62
作者
Albaladejo, Pierre [1 ]
Bonhomme, Fanny [2 ]
Blais, Normand [3 ]
Collet, Jean-Philippe [4 ]
Faraoni, David [5 ]
Fontana, Pierre [6 ]
Godier, Anne [7 ]
Llau, Juan [8 ]
Longrois, Dan [9 ]
Marret, Emmanuel [10 ,11 ]
Mismetti, Patrick [12 ]
Rosencher, Nadia [13 ]
Roullet, Stephanie
Samama, Charles-Marc [14 ]
Schved, Jean-Francois [15 ]
Sie, Pierre [16 ]
Steib, Annick [17 ]
Susen, Sophie [18 ]
机构
[1] Univ Grenoble Alpes, Grenoble Univ Hosp, ThEMAS, Dept Anesthesiol & Intens Care Med,TIMC,UMR CNRS, F-38043 Grenoble, France
[2] Univ Hosp Geneva, Div Anesthesiol, Geneva, Switzerland
[3] Univ Montreal, CHUM Hop Notre Dame, Dept Med, Montreal, PQ, Canada
[4] Univ Paris 06 UPMC, Hop Pitie Salpetriere, AP HP, Inst Cardiol,ACTION Study Grp, Paris, France
[5] Harvard Med Sch, Boston Childrens Hosp, Dept Anesthesiol Perioperat & Pain Med, Boston, MA USA
[6] Univ Hosp Geneva, Div Angiol & Haemostasis, Geneva, Switzerland
[7] Fdn Ophtalmol Adolphe Rothschild, Paris, France
[8] Hosp Clin Univ, Dept Anesthesiol & Crit Care, Valencia, Spain
[9] Univ Paris Diderot, Hop Bichat Claude Bernard, Dept Anesthesie Reanimat, INSERM,Sorbonne Paris Cite,U1148, Paris, France
[10] Amer Hosp Paris, Dept Anesthesiol, Neuilly Sur Seine, France
[11] Inst Hosp Franco Britann, Levallois Perret, France
[12] Ctr Hosp Univ St Etienne, Serv Med Vasc & Therapeut, St Etienne, France
[13] Paris Descartes Univ, Cochin & Hotel Dieu Univ Hosp, Dept Anaesthesia & Intens Care Med, Paris, France
[14] CHU Bordeaux, Hop Pellegrin, Serv Anesthesie Reanimat 1, Bordeaux, France
[15] CHU Montpellier, Dept Hematol, Montpellier, France
[16] Toulouse Univ Hosp, Dept Hematol, Toulouse, France
[17] Univ Hosp, Dept Anesthesiol & Intens Care, Strasbourg, France
[18] Univ Lille 2, Lille Univ Hosp, Inst Pasteur Lille, INSERM UMR 1011,EGID,Dept Hematol & Transfus, Lille, France
关键词
Direct oral anticoagulants; Elective surgery; Periprocedural management; NONVALVULAR ATRIAL-FIBRILLATION; LONG-TERM TREATMENT; DABIGATRAN; WARFARIN; RIVAROXABAN; INTERRUPTION; THROMBIN; OUTCOMES; TRIAL;
D O I
10.1016/j.accpm.2016.09.002
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Since 2011, data on patients exposed to direct oral anticoagulants (DOAs) while undergoing invasive procedures have accumulated. At the same time, an increased hemorrhagic risk during perioperative bridging anticoagulation without thrombotic risk reduction has been demonstrated. This has led the GIHP to update their guidelines published in 2011. For scheduled procedures at low bleeding risk, it is suggested that patients interrupt DOAs the night before irrespective of type of drug and to resume therapy six hours or more after the end of the invasive procedure. For invasive procedures at high bleeding risk, it is suggested to interrupt rivaroxaban, apixaban and edoxaban three days before. Dabigatran should be interrupted according to the renal function, four days and five days if creatinine clearance is higher than 50 mL/min and between 30 and 50 mL/min, respectively. For invasive procedures at very high bleeding risk such as intracranial neurosurgery or neuraxial anesthesia, longer interruption times are suggested. Finally, bridging with parenteral anticoagulation and measurement of DOA concentrations can no longer routinely be used. (C) 2016 Societe francaise d'anesthesie et de reanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:73 / 76
页数:4
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