1/
Second day of @Smart_Meeting_M
Professor @giovannilandoni talking about management of #anticoagulant in #perioperative patients 💉
✅You surely all know how to deal with #antithrombotic and #regionalanesthesia, here the guidelines:
pubmed.ncbi.nlm.nih.gov/34980845/
#FOAMed #FOAMcc
2/
💡Let's focus on perioperative #DOAC /#NOAC / #TSOAC
➡️Consider both #surgical blood loss risk and #patient characteristics.
⚠️Remember NOT to bridge with #LMWH or #UFH.
pubmed.ncbi.nlm.nih.gov/33895845/
3/
What if it's not an elective patient??
Use #reversal agents when needed❗
🔹#Idarucizumab for #dabigatran
🔹#Andexanet for #apixaban and #rivaroxaban
💡#Prothrombin complex concentrates in addiction
pubmed.ncbi.nlm.nih.gov/36988142/
4/
Case report: #hemorrhage in patient on #tPA
➡️ Use #Tranexamic acid immediatly!
But pay attention❗
✅ Beneficial within the first 3 hours
🚫 Detrimental after 3 hours
5/
Case report: hemorrhage in patient on #UFH
➡️ Use #Protamine sulfate
🚫 Not 1:100 with #heparin ➡️ elongation of clotting time
✅ But 2/3 of the dosage ➡️ full reversal without clotting issues (link)
➡️Protamine is useful also for #LMWH❗
pubmed.ncbi.nlm.nih.gov/26495270/
6/
Case report: patient on #Aspirin with microvascular bleeding after surgery
➡️ Use #Desmopressin (DDAVP)
pubmed.ncbi.nlm.nih.gov/27117753/
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