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37 - Reversal of Anticoagulation

from Section 8 - Hematology–Oncology Emergencies

Published online by Cambridge University Press:  02 November 2023

Kaushal Shah
Affiliation:
Weill Cornell Medical Center, New York
Jarone Lee
Affiliation:
Massachusetts General Hospital, Boston
Clark G. Owyang
Affiliation:
Weill Cornell Medical Center, New York
Benjamin Christian Renne
Affiliation:
Massachusetts General Hospital, Boston
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Summary

  • The use of direct oral anticoagulants (e.g., dabigatran, rivaroxaban, apixaban, edoxaban) over more traditional agents such as warfarin has significantly increased over the past decade. These patients require prompt reversal of their bleeding diathesis during resuscitation.

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Chapter
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Publisher: Cambridge University Press
Print publication year: 2023

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References

Baugh, CW, Levine, M, Cornutt, D, et al. Anticoagulant reversal strategies in the emergency department setting: recommendations of a multidisciplinary expert panel. Ann Emerg Med 2020;76(4):470485.CrossRefGoogle ScholarPubMed
Bliden, KP, Chaudhary, R, Mohammed, N, et al. Determination of non-Vitamin K oral anticoagulant (NOAC) effects using a new-generation thrombelastography TEG 6s system. J Thromb Thrombolysis 2017;43(4):437445.CrossRefGoogle ScholarPubMed
Connolly, SJ, Crowther, M, Eikelboom, JW, et al. Full study report of andexanet alfa for bleeding associated with Factor Xa inhibitors. N Engl J Med 2019;380(14):13261335.CrossRefGoogle ScholarPubMed
Pollack, CV, Reilly, PA, van Ryn, J, et al. Idarucizumab for dabigatran reversal — full cohort analysis. N Engl J Med 2017;377(5):431441.CrossRefGoogle ScholarPubMed
Schulman, S, Ritchie, B, Nahirniak, S, et al. Reversal of dabigatran-associated major bleeding with activated prothrombin concentrate: a prospective cohort study. Thromb Res 2017;152:4448.CrossRefGoogle ScholarPubMed
Tomaselli, GF, Mahaffey, KW, Cuker, A, et al. 2017 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants: a report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways. J Am Coll Cardiol 2017;70(24):30423067.CrossRefGoogle Scholar

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