Dabigatran in patients with atrial fibrillation: perioperative and periinterventional management

Weltermann, Ansgar; Brodmann, Marianne; Domanovits, Hans; Eber, Bernd; Gottsauner‐Wolf, Michael; Halbmayer, Walter Michael; Hiesmayr, Jörg Michael; Kyrle, Paul A.; Längle, F.; Roithinger, Franz Xaver; Watzke, Herbert; Windhager, Reinhard; Wolf, Cyrill; Zweiker, Robert

doi:10.1007/s00508-012-0166-5

Cited by 15 publications

(16 citation statements)

References 17 publications

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“…Dabigatran hat sich bereits ohne Verfügbarkeit eines spezifischen Antidots in der Anwendung als zumindest ebenso sicher oder sicherer erwiesen als Warfarin [2]. Empfehlungen zum perioperativen und periinterventionellen Management von Patienten unter Dabigatran und zum Management von Dabigatran-induzierten Blutungen bieten eine Richtschnur für die Präventi-on von Blutungen und das Vorgehen bei Blutungen unter Dabigatran ohne spezifisches Antidot [3].…”

Section: Hintergrundunclassified

Blutungsmanagement bei Patienten unter Therapie mit Dabigatran

Kozek‐Langenecker¹,

Huber

2015

Wien klin Mag

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Section: Hintergrundunclassified

Blutungsmanagement bei Patienten unter Therapie mit Dabigatran

Kozek‐Langenecker¹,

Huber

2015

Wien klin Mag

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“…Auf die initiale Erfassung obengenannter Parameter ist besonderes Augenmerk zu legen [47,55]. [57,61,62,67].…”

Section: Erstaufnahmeunclassified

Ablauforganisation – unfallchirurgisches und anästhesiologisches Management bei Hüftfrakturen

Müller¹,

Gerstorfer

Dovjak³

et al. 2013

Wien Med Wochenschr

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In patients with hip fractures, in order to reduce the high number of general complications and those associated with the specific treatment, the functional loss and cognitive impairment, implementation of co-ordinated, multidisciplinary treatment pathways, and rehabilitation, is mandatory. The imminent treatment of proximal femoral fracture consists of major orthopaedic surgery in most cases (total or partial hip arthroplasty, osteosynthesis). After the diagnosis of a hip fracture, an adequate pain medication should be initiated. The decision making for the fracture treatment includes fracture type, patient's age, cognitive function, mobility before the fall and functional demands of the patient in the context of patients life expectancy and goals of care. The anaesthesiological evaluation focuses on risk assessment. Medical abnormalities should be optimized within 24 to 48 h, or an increased perioperative risk due to comorbidities has to be accepted. The timing and the course of further preoperative diagnostic examinations and therapeutic interventions should be co-ordinated between the involved medical disciplines. After the operation a structured screening for delirium should be initiated and further evaluation of patient's nutrition, fall-associated medication, living conditions and osteoporosis treatment has to be performed.

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“…The (not evidence based) recommendation for Dabigatran: eGFR more than 50 ml/min: Surgery possible after 48 h of termination. eGFR less than 50 ml/min: Surgery possible after termination for 72 h [22,23]. The evidence for validated recommendations for termination of new oral anticoagulants pre-operatively is lacking.…”

Section: Vitamin K-antagonists (Marcoumar Sintrom Warfarin Etc)mentioning

confidence: 99%

“…The evidence for validated recommendations for termination of new oral anticoagulants pre-operatively is lacking. A normal aPTT does not exclude a risk for bleeding with these agents [22]. No antidote is available for these substances.…”

Section: Vitamin K-antagonists (Marcoumar Sintrom Warfarin Etc)mentioning

confidence: 99%

“…Pharmacological data suggests that factor Xa inhibors are best antagonised with prothrombin concentrate complex [23]. In the case of Dabigatran, elimination by haemodialysis is recommended [22,23]. The peri-and post-operative blood loss cannot be reliably assessed, and internationally accepted guidelines are not yet available.…”

Section: Vitamin K-antagonists (Marcoumar Sintrom Warfarin Etc)mentioning

confidence: 99%

See 1 more Smart Citation

Stress ulcer prophylaxis, thromboprophylaxis and coagulation management in patients with hip fractures

Thaler

Dovjak²,

Iglseder

et al. 2013

Wien Med Wochenschr

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Hip fracture in older patients is a major health concern. 20-25 % of hip fracture patients will die in the first year after the trauma (Lane, Clin Orthop Relat Res 471(8):2711, 2013). Postoperative venous thrombosis and gastrointestinal stress-ulcer bleeding are frequent complications with a high case-fatality rate particularly in older patients. Thromboprophylaxis and stress ulcer prophylaxis are important and well established measures to decrease postoperative complications and the mortality rate in this high-risk population.The working group on orthogeriatrics of the Austrian Society on Geriatrics and Gerontology (ÖGGG) is composed of geriatricians who work as trauma surgeons, internists, anaestesists and nurses. A thorough literature search was done, using the terms "orthogeriatrics" and "hip fracture" in combination with "stress ulcer", "gastrointestinal bleeding" and "thrombosis", "thromboprophylaxis". The data was collected, discussed and evaluated in several adjustment meetings of the group and summarized in this article.

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Dabigatran in patients with atrial fibrillation: perioperative and periinterventional management

Cited by 15 publications

References 17 publications

Blutungsmanagement bei Patienten unter Therapie mit Dabigatran

Blutungsmanagement bei Patienten unter Therapie mit Dabigatran

Ablauforganisation – unfallchirurgisches und anästhesiologisches Management bei Hüftfrakturen

Stress ulcer prophylaxis, thromboprophylaxis and coagulation management in patients with hip fractures

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