Difference between revisions of "Dabigatran reversal"
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
| − | *If aPTT is totally normal (<1.5x), unlikely that significant drug effect is present | + | *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== | ==Reversal Protocol== | ||
| Line 14: | Line 15: | ||
#Life-Threatening Bleeding | #Life-Threatening Bleeding | ||
##All above | ##All above | ||
| − | ##Consider | + | ##Consider: |
###rFVIIa | ###rFVIIa | ||
| − | ###PCC | + | ###Prothrombin Complex Concentrate (PCC); (Trad Name = Cofact) |
| + | ####50 IU/kg IV bolus | ||
==Source== | ==Source== | ||
Revision as of 18:21, 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