Difference between revisions of "Dabigatran reversal"

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#Consider Recombinant Factor VIIa (no good data)
 
#Consider Recombinant Factor VIIa (no good data)
 
#Consider Prothrombin Complex Concentrate (PCC): 50 IU/kg IV bolus (no good data)
 
#Consider Prothrombin Complex Concentrate (PCC): 50 IU/kg IV bolus (no good data)
 +
 +
==See Also==
 +
*[[Coagulopathy (Main)]]
  
 
==Source==
 
==Source==
 
*Hennepin County Guidelines
 
*Hennepin County Guidelines
 
*University of Utah Healthcare Thrombosis Service Guidelines
 
*University of Utah Healthcare Thrombosis Service Guidelines
 
==See Also==
 
[[Warfarin (Coumadin) Reversal]]
 
  
 
[[Category:Heme/Onc]]
 
[[Category:Heme/Onc]]
 
[[Category:Drugs]]
 
[[Category:Drugs]]

Revision as of 14:00, 7 January 2014

Background

  • If aPTT is <1.5 x control, it is unlikely that significant drug effect is present
  • Thrombin Time (TT) is most sensitive; normal TT excludes presence of significant dabigatran

Mild Bleeding

  1. Local control measures: direct pressure
  2. Delay next 1-2 doses OR discontinue (as appropriate)

Moderate-Severe Bleeding

  1. Local control measures: direct pressure/surgical intervention
  2. Resuscitate with intravenous fluid and / blood products
  3. Oral charcoal administration if drug taken <2 hours before presentation
  4. Hemodialysis will remove ~60% of drug taken over prior 2-3 hours

Life-Threatening Bleeding

All of the above PLUS

  1. Consider Recombinant Factor VIIa (no good data)
  2. Consider Prothrombin Complex Concentrate (PCC): 50 IU/kg IV bolus (no good data)

See Also

Source

  • Hennepin County Guidelines
  • University of Utah Healthcare Thrombosis Service Guidelines