tailieunhanh - báo cáo hóa học: " Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage: a structured literature review"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành hóa học dành cho các bạn yêu hóa học tham khảo đề tài: Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage: a structured literature review | Bechtel et al. International Journal of Emergency Medicine 2011 4 40 http content 4 1 40 o International Journal of Emergency Medicine a SpringerOpen Journal REVIEW Open Access Treatments for reversing warfarin anticoagulation in patients with acute intracranial hemorrhage a structured literature review 1 2 3 4 1 Brett F Bechtel Timothy C Nunez Jennifer A Lyon Bryan A Cotton and Tyler W Barrett Abstract Study objective The acute management of patients on warfarin with spontaneous or traumatic intracranial hemorrhage continues to be debated in the medical literature. The objective of this paper was to conduct a structured review of the medical literature and summarize the advantages and risks of the available treatment options for reversing warfarin anticoagulation in patients who present to the emergency department with acute intracranial hemorrhage. Methods A structured literature search and review of articles relevant to intracranial hemorrhage and warfarin and treatment in the emergency department was performed. Databases for PubMed CINAHL and Cochrane EBM Reviews were electronically searched using keywords covering the concepts of anticoagulation drugs intracranial hemorrhage ICH and treatment. The results generated by the search were limited to English- language articles and reviewed for relevance to our topic. The multiple database searches revealed 586 papers for review for possible inclusion. The final consensus of our comprehensive search strategy was a total of 23 original studies for inclusion in our review. Results Warfarin not only increases the risk of but also the severity of ICH by causing hematoma expansion. Prothrombin complex concentrate is statistically significantly faster at correcting the INR compared to fresh frozen plasma transfusions. Recombinant factor VIIa appears to rapidly reverse warfarin s effect on INR however this treatment is not FDA-approved and is associated with a 5 thromboembolic event rate. Slow intravenous .