Skip to main content
Erschienen in: Intensive Care Medicine 1/2019

25.04.2018 | What's New in Intensive Care

Ten things ICU specialists need to know about direct oral anticoagulants (DOACs)

verfasst von: Jakob Stensballe, Morten Hylander Møller

Erschienen in: Intensive Care Medicine | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Excerpt

Anticoagulation is the cornerstone in the treatment of thromboembolic disorders. In the intensive care unit (ICU), anticoagulation is often challenging as the balance between bleeding and thrombosis is subtle, and anticoagulation-induced bleeding is associated with adverse outcome [1]. In this paper, we outline ten important things ICU specialists need to know about patients treated with direct oral anticoagulants (DOACs) …
Literatur
1.
2.
Zurück zum Zitat Lopez-Lopez JA, Sterne JAC, Thom HHZ, Higgins JPT, Hingorani AD, Okoli GN, Davies PA, Bodalia PN, Bryden PA, Welton NJ, Hollingworth W, Caldwell DM, Savovic J, Dias S, Salisbury C, Eaton D, Stephens-Boal A, Sofat R (2017) Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. BMJ 359:j5058CrossRefPubMedPubMedCentral Lopez-Lopez JA, Sterne JAC, Thom HHZ, Higgins JPT, Hingorani AD, Okoli GN, Davies PA, Bodalia PN, Bryden PA, Welton NJ, Hollingworth W, Caldwell DM, Savovic J, Dias S, Salisbury C, Eaton D, Stephens-Boal A, Sofat R (2017) Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. BMJ 359:j5058CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Sterne JA, Bodalia PN, Bryden PA, Davies PA, Lopez-Lopez JA, Okoli GN, Thom HH, Caldwell DM, Dias S, Eaton D, Higgins JP, Hollingworth W, Salisbury C, Savovic J, Sofat R, Stephens-Boal A, Welton NJ, Hingorani AD (2017) Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis. Health Technol Assess 21:1–386CrossRefPubMedPubMedCentral Sterne JA, Bodalia PN, Bryden PA, Davies PA, Lopez-Lopez JA, Okoli GN, Thom HH, Caldwell DM, Dias S, Eaton D, Higgins JP, Hollingworth W, Salisbury C, Savovic J, Sofat R, Stephens-Boal A, Welton NJ, Hingorani AD (2017) Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis. Health Technol Assess 21:1–386CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Tomaselli GF, Mahaffey KW, Cuker A, Dobesh PP, Doherty JU, Eikelboom JW, Florido R, Hucker W, Mehran R, Messe SR, Pollack CV Jr, Rodriguez F, Sarode R, Siegal D, Wiggins BS (2017) 2017 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants: a report of the American College of Cardiology Task Force on expert consensus decision pathways. J Am Coll Cardiol 70:3042–3067CrossRefPubMed Tomaselli GF, Mahaffey KW, Cuker A, Dobesh PP, Doherty JU, Eikelboom JW, Florido R, Hucker W, Mehran R, Messe SR, Pollack CV Jr, Rodriguez F, Sarode R, Siegal D, Wiggins BS (2017) 2017 ACC expert consensus decision pathway on management of bleeding in patients on oral anticoagulants: a report of the American College of Cardiology Task Force on expert consensus decision pathways. J Am Coll Cardiol 70:3042–3067CrossRefPubMed
5.
Zurück zum Zitat Potze W, Arshad F, Adelmeijer J, Blokzijl H, van den Berg AP, Meijers JC, Porte RJ, Lisman T (2014) Differential in vitro inhibition of thrombin generation by anticoagulant drugs in plasma from patients with cirrhosis. PLoS One 9:e88390CrossRefPubMedPubMedCentral Potze W, Arshad F, Adelmeijer J, Blokzijl H, van den Berg AP, Meijers JC, Porte RJ, Lisman T (2014) Differential in vitro inhibition of thrombin generation by anticoagulant drugs in plasma from patients with cirrhosis. PLoS One 9:e88390CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Johansson PI, Stensballe J, Vindelov N, Perner A, Espersen K (2010) Hypocoagulability, as evaluated by thrombelastography, at admission to the ICU is associated with increased 30-day mortality. Blood Coagul Fibrinolysis 21:168–174CrossRefPubMed Johansson PI, Stensballe J, Vindelov N, Perner A, Espersen K (2010) Hypocoagulability, as evaluated by thrombelastography, at admission to the ICU is associated with increased 30-day mortality. Blood Coagul Fibrinolysis 21:168–174CrossRefPubMed
8.
Zurück zum Zitat Jensen KOF, Hansen SH, Goetze JP, Jesting A, Stensballe J, Hansen H (2017) Preliminary report: measurement of apixaban and rivaroxaban in plasma from bleeding patients. Eur J Haematol 99:431–436CrossRefPubMed Jensen KOF, Hansen SH, Goetze JP, Jesting A, Stensballe J, Hansen H (2017) Preliminary report: measurement of apixaban and rivaroxaban in plasma from bleeding patients. Eur J Haematol 99:431–436CrossRefPubMed
9.
Zurück zum Zitat Solbeck S, Jensen AS, Maschmann C, Stensballe J, Ostrowski SR, Johansson PI (2018) The anticoagulant effect of therapeutic levels of dabigatran in atrial fibrillation evaluated by thrombelastography (TEG®), hemoclot thrombin inhibitor (HTI) assay and ecarin clotting time (ECT). Scand J Clin Lab Invest 78:25–30CrossRefPubMed Solbeck S, Jensen AS, Maschmann C, Stensballe J, Ostrowski SR, Johansson PI (2018) The anticoagulant effect of therapeutic levels of dabigatran in atrial fibrillation evaluated by thrombelastography (TEG®), hemoclot thrombin inhibitor (HTI) assay and ecarin clotting time (ECT). Scand J Clin Lab Invest 78:25–30CrossRefPubMed
10.
Zurück zum Zitat Dias JD, Norem K, Doorneweerd DD, Thurer RL, Popovsky MA, Omert LA (2015) Use of thromboelastography (TEG) for detection of new oral anticoagulants. Arch Pathol Lab Med 139:665–673CrossRefPubMed Dias JD, Norem K, Doorneweerd DD, Thurer RL, Popovsky MA, Omert LA (2015) Use of thromboelastography (TEG) for detection of new oral anticoagulants. Arch Pathol Lab Med 139:665–673CrossRefPubMed
11.
Zurück zum Zitat Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, Georg HK, Oldgren J, Reinecke H, Roldan-Schilling V, Rowell N, Sinnaeve P, Collins R, Camm AJ, Heidbuchel H (2018) The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. https://doi.org/10.1093/europace/euy054 CrossRefPubMed Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, Georg HK, Oldgren J, Reinecke H, Roldan-Schilling V, Rowell N, Sinnaeve P, Collins R, Camm AJ, Heidbuchel H (2018) The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. https://​doi.​org/​10.​1093/​europace/​euy054 CrossRefPubMed
12.
Zurück zum Zitat Marlu R, Hodaj E, Paris A, Albaladejo P, Crackowski JL, Pernod G (2012) Effect of non-specific reversal agents on anticoagulant activity of dabigatran and rivaroxaban. A randomised crossover ex vivo study in healthy volunteers. Thromb Haemost 108:217–224CrossRefPubMed Marlu R, Hodaj E, Paris A, Albaladejo P, Crackowski JL, Pernod G (2012) Effect of non-specific reversal agents on anticoagulant activity of dabigatran and rivaroxaban. A randomised crossover ex vivo study in healthy volunteers. Thromb Haemost 108:217–224CrossRefPubMed
13.
Zurück zum Zitat Pollack CV Jr, Reilly PA, van Ryn J, Eikelboom JW, Glund S, Bernstein RA, Dubiel R, Huisman MV, Hylek EM, Kam CW, Kamphuisen PW, Kreuzer J, Levy JH, Royle G, Sellke FW, Stangier J, Steiner T, Verhamme P, Wang B, Young L, Weitz JI (2017) Idarucizumab for dabigatran reversal - full cohort analysis. N Engl J Med 377:431–441CrossRefPubMed Pollack CV Jr, Reilly PA, van Ryn J, Eikelboom JW, Glund S, Bernstein RA, Dubiel R, Huisman MV, Hylek EM, Kam CW, Kamphuisen PW, Kreuzer J, Levy JH, Royle G, Sellke FW, Stangier J, Steiner T, Verhamme P, Wang B, Young L, Weitz JI (2017) Idarucizumab for dabigatran reversal - full cohort analysis. N Engl J Med 377:431–441CrossRefPubMed
14.
Zurück zum Zitat Wang X, Mondal S, Wang J, Tirucherai G, Zhang D, Boyd RA, Frost C (2014) Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects. Am J Cardiovasc Drugs 14:147–154CrossRefPubMed Wang X, Mondal S, Wang J, Tirucherai G, Zhang D, Boyd RA, Frost C (2014) Effect of activated charcoal on apixaban pharmacokinetics in healthy subjects. Am J Cardiovasc Drugs 14:147–154CrossRefPubMed
15.
Zurück zum Zitat Stangier J, Rathgen K, Stahle H, Mazur D (2010) Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. Clin Pharmacokinet 49:259–268CrossRefPubMed Stangier J, Rathgen K, Stahle H, Mazur D (2010) Influence of renal impairment on the pharmacokinetics and pharmacodynamics of oral dabigatran etexilate: an open-label, parallel-group, single-centre study. Clin Pharmacokinet 49:259–268CrossRefPubMed
16.
Zurück zum Zitat Henry DA, Carless PA, Moxey AJ, O’Connell D, Stokes BJ, Fergusson DA, Ker K (2011) Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 16(3):001886 Henry DA, Carless PA, Moxey AJ, O’Connell D, Stokes BJ, Fergusson DA, Ker K (2011) Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion. Cochrane Database Syst Rev 16(3):001886
17.
Zurück zum Zitat Beitland S, Sandven I, Kjaervik LK, Sandset PM, Sunde K, Eken T (2015) Thromboprophylaxis with low molecular weight heparin versus unfractionated heparin in intensive care patients: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med 41:1209–1219CrossRefPubMed Beitland S, Sandven I, Kjaervik LK, Sandset PM, Sunde K, Eken T (2015) Thromboprophylaxis with low molecular weight heparin versus unfractionated heparin in intensive care patients: a systematic review with meta-analysis and trial sequential analysis. Intensive Care Med 41:1209–1219CrossRefPubMed
Metadaten
Titel
Ten things ICU specialists need to know about direct oral anticoagulants (DOACs)
verfasst von
Jakob Stensballe
Morten Hylander Møller
Publikationsdatum
25.04.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 1/2019
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-018-5192-y

Weitere Artikel der Ausgabe 1/2019

Intensive Care Medicine 1/2019 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.