Emergency care of patients receiving non-vitamin K antagonist oral anticoagulants

被引：14

作者：

Eikelboom, J. W. ^{[1
,2
]}

Kozek-Langenecker, S. ^{[3
]}

Exadaktylos, A. ^{[4
]}

Batorova, A. ^{[5
,6
]}

Boda, Z. ^{[7
]}

Christory, F. ^{[8
]}

Gornik, I. ^{[9
,23
]}

Kekstas, G. ^{[10
]}

Kher, A. ^{[11
]}

Komadina, R. ^{[12
]}

Koval, O. ^{[13
]}

Mitic, G. ^{[14
,15
]}

Novikova, T. ^{[16
,17
]}

Pazvanska, E. ^{[18
]}

Ratobilska, S. ^{[19
]}

Sutt, J. ^{[20
]}

Winder, A. ^{[21
]}

Zateyshchikov, D. ^{[22
]}

机构：

[1] McMaster Univ, Populat Hlth Res Inst, Hamilton, ON, Canada

[2] Hamilton Hlth Sci, Hamilton, ON, Canada

[3] Evangel Hosp Vienna, Dept Anaesthesia & Intens Care, Vienna, Austria

[4] Bern Univ Hosp, Inselspital, Dept Emergency Med, Bern, Switzerland

[5] Comenius Univ, Fac Med, Dept Haematol & Transfus Med, Bratislava, Slovakia

[6] Univ Hosp, Bratislava, Slovakia

[7] Univ Debrecen, Thrombosis & Haemostasis Ctr, Dept Internal Med, Debrecen, Hungary

[8] Med Educ Global Solut, Paris, France

[9] Univ Hosp Ctr Zagreb, Dept Med, Intens Care Unit, Zagreb, Croatia

[10] Vilnius Univ, Hosp Santariskiu Klin, Dept Anaesthesiol & Intens Care, Vilnius, Lithuania

[11] Hotel Dieu Univ Hosp, Lab Biol Hematol, Paris, France

[12] Gen & Teaching Hosp Celje, Dept Traumatol, Celje, Slovenia

[13] Dnipropetrovsk State Med Acad, Dept Hosp Therapy 2, Dnepropetrovsk, Ukraine

[14] Univ Novi Sad, Clin Ctr Vojvodina, Ctr Lab Med, Thrombosis & Haemostasis Unit, Novi Sad, Serbia

[15] Univ Novi Sad, Fac Med, Novi Sad, Serbia

[16] Northwestern Med Univ II Mechnikov, Dept Cardiol, St Petersburg, Russia

[17] Pokrovskaya City Hosp, Vasc Ctr, St Petersburg, Russia

[18] 4th City Hosp, Dept Anaesthesia & Intens Care, Sofia, Bulgaria

[19] Pauls Stradins Clin Univ Hosp, Intens Care Unit, Riga, Latvia

[20] Tartu Univ Hosp, Anaesthesiol & Intens Care Clin, Tartu, Estonia

[21] Wolfson Med Ctr, Dept Hematol, Thrombosis & Hemostasis Unit, Holon, Israel

[22] City Clin Hosp 51, Primary Vasc Dept, Moscow, Russia

[23] Univ Zagreb, Sch Med, Zagreb, Croatia

来源：

BRITISH JOURNAL OF ANAESTHESIA | 2018年 / 120卷 / 04期

关键词：

anticoagulants; coagulation monitoring; emergencies; haemorrhage; reversal; PROTHROMBIN COMPLEX CONCENTRATE; ACTIVATED FACTOR-VII; COAGULATION ASSAYS; THROMBIN GENERATION; VISCOELASTIC COAGULATION; DABIGATRAN ETEXILATE; EUROPEAN-SOCIETY; ANDEXANET ALPHA; PRACTICAL GUIDE; IN-VITRO;

D O I：

10.1016/j.bja.2017.11.082

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Non-vitamin K antagonist oral anticoagulants (NOACs), which inhibit thrombin (dabigatran) and factor Xa (rivaroxaban, apixaban, edoxaban) have been introduced in several clinical indications. Although NOACs have a favourable benefit-risk profile and can be used without routine laboratory monitoring, they are associatedeas any anticoagulantewith a risk of bleeding. In addition, treatment may need to be interrupted in patients who need surgery or other procedures. The objective of this article, developed by a multidisciplinary panel of experts in thrombosis and haemostasis, is to provide an update on the management of NOAC-treated patients who experience a bleeding episode or require an urgent procedure. Recent advances in the development of targeted reversal agents are expected to help streamline the management of NOAC-treated patients in whom rapid reversal of anticoagulation is required.

引用

页码：645 / 656

页数：12

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