Activated prothrombin complex in the management of direct thrombin inhibitor-associated intracerebral haemorrhage

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Activated prothrombin complex in the management of direct thrombin inhibitor-associated intracerebral haemorrhage.

A 78 year-old man developed sudden-onset aphasia and right hemiparesis 14 days after hospitalisation for severe cellulitis, for which he was receiving meropenem and clindamycin. His medical history included a porcine aortic valve replacement and atrial fibrillation treated with dabigatran (a direct thrombin inhibitor, DTI) 150mg twice daily. His weight was 79kg, body mass index 25mg/m, and esti...

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Hemostatic therapy in experimental intracerebral hemorrhage associated with the direct thrombin inhibitor dabigatran.

BACKGROUND AND PURPOSE Dabigatran-etexilate (DE) recently has been approved for stroke prevention in atrial fibrillation. However, lack of effective antagonists represents a major concern in the event of intracerebral hemorrhage (ICH). The aims of the present study were to establish a murine model of ICH associated with dabigatran, and to test the efficacy of different hemostatic factors in pre...

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This report describes the management of a bleedinq episode following exodontia in a patient with severe hemophilia A and inhibitor to Factor VIII. For this patient activated prothrombin complex concentrates provided an effective method of controlling hemorrhage. Maintaining hemostasis in the surgical patient who has hemophilia A and inhibitor to Factor VIII is a difficult challenge for dentists...

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We would treat with 4-factor PCCs because otherwise—with an INR of 1.9—there is a high risk of further expansion of an already large ICH. Without reversal of the anticoagulant effects of warfarin, the patient’s life is at stake. At age 65 years, he has a reasonable chance to recover from a right-sided ICH if treated early and aggressively. In our eyes, early withdrawal of care is not an option!...

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The direct thrombin inhibitor hirudin.

This review discusses the pharmacology and clinical applications of hirudin, a bivalent direct thrombin inhibitor (DTI). Besides the current major indication for hirudin--anticoagulation of patients with heparin-induced thrombocytopenia (HIT)--the experience with hirudin in other indications, especially acute coronary syndromes, are briefly presented. Hirudins have been formally studied prior t...

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ژورنال

عنوان ژورنال: QJM

سال: 2015

ISSN: 1460-2725,1460-2393

DOI: 10.1093/qjmed/hcv219