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Verfasst von:Laible, Mona [VerfasserIn]   i
 Beynon, Christopher [VerfasserIn]   i
 Sander, Peter [VerfasserIn]   i
 Purrucker, Jan [VerfasserIn]   i
 Müller, Oliver J. [VerfasserIn]   i
 Möhlenbruch, Markus Alfred [VerfasserIn]   i
 Ringleb, Peter A. [VerfasserIn]   i
 Rizos, Timolaos [VerfasserIn]   i
Titel:Treatment with prothrombin complex concentrate to enable emergency lumbar puncture in patients receiving vitamin K antagonists
Verf.angabe:Mona Laible, Christopher Beynon, Peter Sander, Jan Purrucker, Oliver Josef Müller, Markus Möhlenbruch, Peter Arthur Ringleb, Timolaos Rizos
E-Jahr:2016
Jahr:14 April 2016
Umfang:5 S.
Fussnoten:Gesehen am 08.02.2018
Titel Quelle:Enthalten in: Annals of emergency medicine
Ort Quelle:St. Louis, Mo. : Mosby, 1980
Jahr Quelle:2016
Band/Heft Quelle:68(2016), 3, Seite 340-344
ISSN Quelle:1097-6760
Abstract:Study objective Lumbar punctures are frequently necessary in neurologic emergencies, but effective oral anticoagulation with vitamin K antagonists represents a contraindication. We report the effectiveness of prothrombin complex concentrates to reverse vitamin K antagonist to enable emergency lumbar punctures, as well as evaluate lumbar puncture- and prothrombin complex concentrates-related complications. Methods Consecutive patients treated with prothrombin complex concentrates between December 2004 and June 2014 to enable emergency lumbar puncture were included. International normalized ratio (INR) before and after prothrombin complex concentrates treatment and the time between start of reversal treatment and lumbar puncture were recorded. A target INR of less than or equal to 1.5 was defined as effective prothrombin complex concentrates treatment. Bleeding events, thromboembolic events, and allergic reactions after prothrombin complex concentrates treatment were identified and classified as “related,” “probably,” “possibly,” “unlikely related,” or “not related” to the lumbar puncture and prothrombin complex concentrates infusion. Results Thirty-seven patients were included (64.9% men; median age 76.0 years; interquartile range [IQR] 71.0 to 84.0 years). The intervention with prothrombin complex concentrates was effective in 33 of 37 patients (89.2%; 95% confidence interval [CI], 78.4% to 97.3%). The median INR was 2.2 (IQR 1.8 to 2.9; 95% CI, 1.9 to 2.5) before and 1.3 (IQR 1.2 to 1.4; 95% CI, 1.2 to 1.3) after prothrombin complex concentrates treatment. The median time between start of prothrombin complex concentrates treatment and lumbar puncture was 135 minutes (IQR 76 to 266 minutes; 95% CI, 84 to 198 minutes). One clinically irrelevant intracranial subdural hematoma “related” to the lumbar puncture developed. No allergic reaction was observed, but 2 of 37 patients (5.4%; 95% CI, 0% to 13.5%) experienced a thromboembolic event (1 ischemic stroke, classified “unlikely related,” and 1 myocardial infarction, “possibly related” to prothrombin complex concentrates treatment). Conclusion Reversing the effect of vitamin K antagonist with prothrombin complex concentrates to enable emergency lumbar puncture appears effective and safe, particularly in regard to bleeding events.
DOI:doi:10.1016/j.annemergmed.2016.03.003
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Volltext: http://dx.doi.org/10.1016/j.annemergmed.2016.03.003
 Volltext: http://www.sciencedirect.com/science/article/pii/S019606441600158X
 DOI: https://doi.org/10.1016/j.annemergmed.2016.03.003
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1568621051
Verknüpfungen:→ Zeitschrift

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