Status: Bibliographieeintrag
Standort: ---
Exemplare:
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| Online-Ressource |
Verfasst von: | Schöchl, Herbert [VerfasserIn]  |
| Grottke, Oliver [VerfasserIn]  |
| Schmitt, Felix [VerfasserIn]  |
Titel: | Direct oral anticoagulants in trauma patients |
Verf.angabe: | Herbert Schöchl, Oliver Grottke, Felix C.F. Schmitt |
E-Jahr: | 2024 |
Jahr: | April 2024 |
Umfang: | 8 S. |
Fussnoten: | Gesehen am 08.01.2025 |
Titel Quelle: | Enthalten in: Current opinion in anaesthesiology |
Ort Quelle: | London : Lippincott Williams & Wilkins, 1988 |
Jahr Quelle: | 2024 |
Band/Heft Quelle: | 37(2024), 2 vom: Apr., Seite 93-100 |
ISSN Quelle: | 1473-6500 |
Abstract: | Purpose of review - Direct oral anticoagulants (DOACs) are increasingly prescribed for prevention of thromboembolic events. Thus, trauma care providers are facing a steadily raising number of injured patients on DOACs. - Recent findings - Despite a predictable pharmacokinetic profile, the resulting plasma levels of trauma patients upon admission and bleeding risks remain uncertain. Therefore, recent guidelines recommend the measurement of DOAC plasma concentrations in injured patients. Alternatively, DOAC specific visco-elastic tests assays can be applied to identify DOAC patients at bleeding risk. - Bleeding complications in trauma patients on DOACs are generally higher compared to nonanticoagulated subjects, but comparable to vitamin K antagonists (VKAs). In particular, a traumatic brain injury does not carry an increased risk of intracranial bleeding due to a DOAK intake compared to VKAs. Current studies demonstrated that up to 14% of patients with a hip fracture are on DOACs prior to surgery. However, the majority can be operated safely within a 24h time window without an increased bleeding rate. - Specific antagonists facilitate rapid reversal of patients on DOACs. Idarucizumab for dabigatran, and andexanet alfa for apixaban and rivaroxaban have been approved for life threatening bleeding. Alternatively, prothrombin complex concentrate can be used. Dialysis is a potential treatment option for dabigatran and haemoabsorption with special filters can be applied in patients on FXa-inhibitors. - Summary - Current guidelines recommend the measurement of DOAC plasma levels in trauma patients. Compared to VKAs, DOACs do not carry a higher bleeding risk. DOAC specific antagonists facilitate the individual bleeding management. |
DOI: | doi:10.1097/ACO.0000000000001356 |
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: https://doi.org/10.1097/ACO.0000000000001356 |
| Volltext: https://journals.lww.com/co-anesthesiology/abstract/2024/04000/direct_oral_anticoagulants_in_trauma_patients.2.aspx |
| DOI: https://doi.org/10.1097/ACO.0000000000001356 |
Datenträger: | Online-Ressource |
Sprache: | eng |
K10plus-PPN: | 1913793621 |
Verknüpfungen: | → Zeitschrift |
Direct oral anticoagulants in trauma patients / Schöchl, Herbert [VerfasserIn]; April 2024 (Online-Ressource)
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