Emergency cardiac surgery for patients on NOACs in the NOAC era - Perspective.
Int J Surg
; 87: 105893, 2021 Mar.
Article
em En
| MEDLINE
| ID: mdl-33577930
ABSTRACT
Excessive bleeding is an important cause of morbidity and mortality after cardiac surgery. Bleeding after cardiac surgery is multifactorial. Adherence to the proverbial 6 Ps remains the cornerstone of any strategy for management of postoperative bleeding after cardiac surgery. Recent years have seen a surge in the number of patients who have been prescribed novel oral anticoagulants (NOACs) for the prevention and treatment of thromboembolic events. This phenomenon has significant repercussions particularly for patients presenting for emergency cardiac surgery. The published evidence guiding management of such patients is limited and in the form of expert consensus. Plasma levels of NOAC >30 ng/ml necessitate specific therapeutic interventions to tackle excessive bleeding attributed to NOAC intake. Current recommendation is to consider using specific reversal agent if available. Otherwise, use of prothrombin complex concentrates is recommended.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hemorragia Pós-Operatória
/
Procedimentos Cirúrgicos Cardíacos
/
Anticoagulantes
Tipo de estudo:
Guideline
Limite:
Humans
Idioma:
En
Revista:
Int J Surg
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Reino Unido