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首页> 外文期刊>Italian Journal of Medicine >Management of major bleeding in patients treated with direct oral anticoagulants: from experience to standardized protocols
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Management of major bleeding in patients treated with direct oral anticoagulants: from experience to standardized protocols

机译：直接口服抗凝剂治疗的患者的重大出血管理：从经验到标准化方案

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Evaluation of clinical-laboratory-therapeutic management and related clinical outcomes (thrombotic-hemorrhagic complications) of patients undergoing treatment with direct oral anticoagulants (DOACs) during major bleeding. This is a two-year observational retrospective study. 27 cases of major bleeding in patients undergoing a therapy with DOACs presented to the Emergency Department of Arcispedale Santa Maria Nuova (Reggio Emilia Hospital). 16 cases (59%) underwent reversal of anticoagulation treatment: 19% using specific reversal therapy (idarucizumab) and 81% using non-specific agents [4-factor prothrombin complex concentrate (4F-PCC)]. Routine laboratory data were available for all the cases, but only for some patients it was possible to obtain the plasma dosage of the oral anticoagulant. Laboratory data confirm rapid correction of activated partial thromboplastin time within one hour from the reversal of anticoagulation with idarucizumab. The absence of correlation between standard blood tests and plasma drug dosage in patients treated with factor Xa Inhibitors was confirmed too. The management of major bleeding during treatment with DOACs using reversal therapy (idarucizumab) and non-specific reversal agent (4F-PCC) showed minimal thrombotic (0.3%) and hemorrhagic (0.3%) complications at 90 days; no events occurred after 6 months.
机译：临床 - 实验室治疗管理及相关临床结果（血栓性出血并发症）在重大出血期间进行治疗患者的治疗患者。这是一个两年的观察性回顾性研究。 27例患者进行治疗患者的重大出血，提交给Arcispepeale Santa Maria Nuova（Reggio Emilia医院）的急诊部门。 16例（59％）接受抗凝治疗逆转：19％使用特定逆转治疗（idarucizumab）和81％使用非特异性药剂[4系子凝血酶原浓缩物（4F-PCC）]。常规实验室数据可用于所有案例，但仅适用于一些患者，可以获得口腔抗凝剂的血浆剂量。实验室数据确认从抗肌肌氨酸逆转的抗凝血逆转后1小时内快速校正活化的部分凝血形成素时间。缺乏用因子XA抑制剂治疗的患者的标准血液试验和血浆药物剂量之间的相关性。使用逆转疗法（idarucizumab）和非特异性逆转剂（4F-PCC）治疗在治疗过程中的重大出血的管理显示最小血栓形成（0.3％）和出血（0.3％）并发症在90天; 6个月后没有事件发生。

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