Difference between revisions of "Dabigatran reversal"
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==Mild Bleeding== | ==Mild Bleeding== | ||
| − | + | *Local control measures: direct pressure | |
| − | + | *Delay next 1-2 doses OR discontinue (as appropriate) | |
==Moderate-Severe Bleeding== | ==Moderate-Severe Bleeding== | ||
| − | + | *Local control measures: direct pressure/surgical intervention | |
| − | + | *Resuscitate with intravenous fluid and / blood products | |
| − | + | *Oral [[charcoal]] administration ''if drug taken <2 hours before presentation'' | |
| − | + | *Hemodialysis will remove ~60% of drug taken over prior 2-3 hours | |
==Life-Threatening Bleeding== | ==Life-Threatening Bleeding== | ||
All of the above PLUS | All of the above PLUS | ||
| − | + | *Consider Recombinant Factor VIIa (no good data) | |
| − | + | *Consider Prothrombin Complex Concentrate (PCC): 50 IU/kg IV bolus (no good data) | |
==See Also== | ==See Also== | ||
Revision as of 18:34, 29 May 2015
Contents
Background
- If aPTT is <1.5 x control, it is unlikely that significant drug effect is present
- Thrombin Time (TT) is most sensitive; normal TT excludes presence of significant dabigatran
Mild Bleeding
- Local control measures: direct pressure
- Delay next 1-2 doses OR discontinue (as appropriate)
Moderate-Severe Bleeding
- Local control measures: direct pressure/surgical intervention
- Resuscitate with intravenous fluid and / blood products
- Oral charcoal administration if drug taken <2 hours before presentation
- Hemodialysis will remove ~60% of drug taken over prior 2-3 hours
Life-Threatening Bleeding
All of the above PLUS
- Consider Recombinant Factor VIIa (no good data)
- Consider Prothrombin Complex Concentrate (PCC): 50 IU/kg IV bolus (no good data)
See Also
Source
- Hennepin County Guidelines
- University of Utah Healthcare Thrombosis Service Guidelines