Matteo Aldo Bonizzoni, MD Profile picture
May 25, 2023 7 tweets 10 min read Read on X
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 Image
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/ Image
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/ Image
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 Image
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/ Image

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Matteo Aldo Bonizzoni, MD

Matteo Aldo Bonizzoni, MD Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @MABonizzoni

May 24, 2023
1/

🎬 Now on stage Professor @giovannilandoni talking about what we DON'T KNOW about #cardiocirculatory drugs

#Norepineprhine is the most used vasoactive drug in the guidelines for:

🔹 #sepsis
🔹#cardiogenic shock❗(Scandinavian)

BUT...

@Smart_Meeting_M @SRAnesthesiaICU Image
2/

BUT... #Norepineprhine (base) does not exist❗

🚫 base is not soluble, unstable and unable to reach target receptors
💡 Let's make it a salt!
🤔 But which one?

⚠️ Available Norepineprhine salts has different #dilution
⚠️ Sometimes with misleading #labeling Image
3/

➡️ Please do not change you're clinical practice for this ⬅️

But consider the possible implications on:

🔹Second line drugs initiation
🔹Co- administration of other vasopressors
❗Comunication of your results!!!

pubmed.ncbi.nlm.nih.gov/36978126/

#FOAMed #FOAMcc Image
Read 8 tweets

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Follow Us!

:(