Management of Severe Dabigatran-Related Hemorrhage: Case Report, Considerations for Management, and Recommendations

Ian Plener; Sharon Sadry; Lee Mozessohn; Justin Y Lee; Damen Man; Nadine Shehata; Jeffrey M Singh

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Management of Severe Dabigatran-Related Hemorrhage: Case Report, Considerations for Management, and Recommendations

机译：重度达比加群相关出血的治疗：病例报告，管理注意事项和建议

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Dabigatran is a direct thrombin inhibitor recently approved in the United States and Canada for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Although dabigatran is administered as a fixed dose, does not interact with foods, and has fewer drug interactions than warfarin, the risk of hemorrhagic complications is similar for these two drugs.12 There is no specific reversal agent for dabigatran, and reversal of coagulopathy in the event of severe hemorrhage can be challenging. With growing use of dabigatran for long-term anticoagulation, it is important that acute care providers have a standardized and evidence-based approach to treating patients with severe hemorrhage secondary to dabigatran. We report a case of severe gastrointestinal hemorrhage related to dabigatran and discuss die management of severe hemorrhage in this context.

机译：达比加群是一种直接的凝血酶抑制剂，最近在美国和加拿大被批准用于预防非瓣膜性房颤的中风和全身性栓塞。尽管达比加群的给药是固定剂量的，与食物不发生相互作用，并且与华法林的相互作用较小，但是这两种药物的出血并发症风险相似。12达比加群没有特效逆转剂，而阿司匹林没有凝血功能逆转。严重出血事件可能具有挑战性。随着达比加群用于长期抗凝治疗的日益增长，重要的是，急救人员必须采用标准化且循证的方法来治疗继发于达比加群的严重出血患者。我们报告了一例与达比加群有关的严重胃肠道出血，并在此背景下讨论了严重出血的死亡管理。

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《The Canadian journal of hospital pharmacy.》 |2014年第1期|共5页
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Ian Plener; Sharon Sadry; Lee Mozessohn; Justin Y Lee; Damen Man; Nadine Shehata; Jeffrey M Singh;
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机译：重度达比加群相关出血的治疗：病例报告，管理注意事项和建议
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机译：管理报告：有关遵守AICPA建议以及对财务分析管理报告的用途的研究。
6. Management of Severe Dabigatran-Related Hemorrhage: Case Report Considerations for Management and Recommendations [O] . Ian Plener, Sharon Sadry, Lee Mozessohn, 2014

机译：重度达比加群相关出血的治疗：病例报告管理注意事项和建议
7. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation31This document was approved by the American College of Cardiology Board of Trustees in August 2001, the American Heart Association Science Advisory and Coordinating Committee in August 2001, and the European Society of Cardiology Board and Committee for Practice Guidelines and Policy Conferences in August 2001.32When citing this document, the American College of Cardiology, the American Heart Association, and the European Society of Cardiology would appreciate the following citation format: Fuster V, Rydén LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, Halperin JL, Kay GN, Klein WW, Lévy S, McNamara RL, Prystowsky EN, Wann LS, Wyse DG. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation). J Am Coll Cardiol 2001;38:XX-XX.33This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org), the American Heart Association (www.americanheart.org), the European Society of Cardiology (www.escardio.org), and the North American Society of Pacing and Electrophysiology (www.naspe.org). Single reprints of this document (the complete Guidelines) to be published in the mid-October issue of the European Heart Journal are available by calling +44.207.424.4200 or +44.207.424.4389, faxing +44.207.424.4433, or writing Harcourt Publishers Ltd, European Heart Journal, ESC Guidelines – Reprints, 32 Jamestown Road, London, NW1 7BY, United Kingdom. Single reprints of the shorter version (Executive Summary and Summary of Recommendations) published in the October issue of the Journal of the American College of Cardiology and the October issue of Circulation, are available for $5.00 each by calling 800-253-4636 (US only) or by writing the Resource Center, American College of Cardiology, 9111 Old Georgetown Road, Bethesda, Maryland 20814. To purchase bulk reprints specify version and reprint number (Executive Summary 71-0208; full text 71-0209) up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 214-706-1466, fax 214-691-6342; or E-mail: pubauth@heart.org. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology [O] . Fuster Valentin, Rydén Lars E., Asinger Richard W., 2001

机译：ACC / AHA / ESC治疗房颤患者指南31该文件于2001年8月获得美国心脏病学会董事会，2001年8月美国心脏协会科学咨询与协调委员会以及欧洲心脏病学会的批准以及实践指南和政策委员会会议（2001年8月）。32引用本文件时，美国心脏病学会，美国心脏协会和欧洲心脏病学会将赞赏以下引用格式：Fuster V，RydénLE，Asinger RW，Cannom DS，Crijns HJ，Frye RL，Halperin JL，Kay GN，Klein WW，LévyS，McNamara RL，Prystowsky EN，Wann LS，Wyse DG。 ACC / AHA / ESC治疗房颤患者的指南：美国心脏病学会/美国心脏协会实践指南工作组和欧洲心脏病学会实践指南委员会和政策会议的报告（制定指南委员会）用于房颤患者的治疗）。 J Am Coll Cardiol 2001; 38：XX-XX.33本文件可在美国心脏病学会（www.acc.org），美国心脏协会（www.americanheart.org），欧洲的万维网站点上找到心脏病学会（www.escardio.org）和北美起搏和电生理学会（www.naspe.org）。可致电+44.207.424.4200或+44.207.424.4389，传真+44.207.424.4433或写信给Harcourt Publishers，以获取本文档（完整的准则）的单份重印本（完整的准则），该印刷本将于10月中旬出版。欧洲心脏杂志，ESC指南–转载，英国伦敦詹姆斯敦路32号，NW1 7BY。短版（执行摘要和建议摘要）的单版重印在《美国心脏病学会杂志》十月刊和《循环》十月刊上，致电800-253-4636（仅美国），每本售价5.00美元。）或写信给美国心脏病学院资源中心，地址是：马里兰州贝塞斯达市Old Georgetown Road 9111，邮编20814。要购买批量转载，请指定版本和转载编号（执行摘要71-0208；全文71-0209），最多999份，致电800-611-6083（仅限美国）或传真413-665-2671； 1000或更多副本，请致电214-706-1466，传真214-691-6342;或电子邮件：pubauth@heart.org。美国心脏病学会/美国心脏协会实践指南工作组和欧洲心脏病学会实践指南和政策会议（制定房颤患者治疗指南委员会）的报告是与北方合作开发的美国起搏与电生理学会

Management of Severe Dabigatran-Related Hemorrhage: Case Report, Considerations for Management, and Recommendations

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