6533b82bfe1ef96bd128e036

RESEARCH PRODUCT

Manejo perioperatorio de los anticoagulantes orales directos en cirugía urgente y sangrado. Monitorización y tratamiento hemostático

L.m. TorresPilar SierraFrancisco HidalgoA. Gómez-luqueR. FerrandisCastillo JJuan V. LlauCarmen GomarJ. De Andrés

subject

Prothrombin timeRivaroxabanmedicine.diagnostic_testbusiness.industryPerioperativeCritical Care and Intensive Care MedicineDabigatranAnesthesiology and Pain MedicineCoagulationAnesthesiamedicineApixabanElective surgerybusinessmedicine.drugPartial thromboplastin time

description

There is an almost unanimous consensus on the management of the direct new oral anticoagulants, dabigatran, rivaroxaban, and apixaban in elective surgery. However, this general consensus does not exist in relation with the direct new oral anticoagulants use in emergency surgery, especially in the bleeding patient. For this reason, a literature review was performed using the MEDLINE-PubMed. An analysis was made of the journal articles, reviews, systematic reviews, and practices guidelines published between 2000 and 2014 using the terms "monitoring" and "reversal". From this review, it was shown that the routine tests of blood coagulation, such as the prothrombin time and activated partial thromboplastin time, have a limited efficacy in the perioperative control of blood coagulation in these patients. There is currently no antidote to reverse the effects of these drugs, although the possibility of using concentrated prothrombin complex and recombinant activated factor vii has been suggested for the urgent reversal of the anticoagulant effect.

yearjournalcountryeditionlanguage
2015-10-01Revista Española de Anestesiología y Reanimación
https://doi.org/10.1016/j.redar.2015.01.002