Dabigatran reversal: Difference between revisions
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Hennipin County Guidelines | *Hennipin County Guidelines | ||
University of Utah Healthcare Thrombosis Service Guidelines | *University of Utah Healthcare Thrombosis Service Guidelines | ||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
[[Category:Drugs]] | [[Category:Drugs]] |
Revision as of 18:26, 9 June 2012
Background
- If aPTT is totally normal (<1.5x control), it is unlikely that significant drug effect is present
- Thrombin Time (TT) is most sensitive; normal TT excludes presence of significant dabigatran
Reversal Protocol
- Mild Bleeding
- Local control measures
- Delay next 1-2 dose OR discontinue as appropriate
- Moderate-Severe Bleeding
- Local control measures/surgical intervention
- Symptomatic treatment
- Fluids/blood/monitoring
- Oral charcoal administration (if taken <2hrs before)
- Hemodialysis (removes 60% over 2-3hrs)
- Life-Threatening Bleeding
- All above
- Consider:
- rFVIIa
- Prothrombin Complex Concentrate (PCC); (Trad Name = Cofact)
- 50 IU/kg IV bolus
Source
- Hennipin County Guidelines
- University of Utah Healthcare Thrombosis Service Guidelines