tailieunhanh - Báo cáo y học: "Bench-to-bedside review: Optimising emergency reversal of vitamin K antagonists in severe haemorrhage – from theory to practice"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Bench-to-bedside review: Optimising emergency reversal of vitamin K antagonists in severe haemorrhage – from theory to practice. | Available online http content 13 2 209 Review Bench-to-bedside review Optimising emergency reversal of vitamin K antagonists in severe haemorrhage - from theory to practice Bernard Vigué AP-HP Université Paris-Sud Hôpital de Bicêtre Département d Anesthésie-Réanimation F-94275 Le Kremlin-Bicêtre France Corresponding author Bernard Vigué Published 22 April 2009 Critical Care 2009 13 209 doi cc7001 This article is online at http content 13 2 209 2009 BioMed Central Ltd Abstract Critical care physicians are increasingly facing patients receiving oral anticoagulation for either cessation of major haemorrhage or to reverse the effects of vitamin K antagonists ahead of emergency surgery. Rapid reversal of anticoagulation is particularly essential in cases of life-threatening bleeding. In these situations guidelines recommend the concomitant administration of prothrombin complex concentrates PCCs and oral or intravenous vitamin K for the fastest normalisation of the international normalised ratio INR . Despite their universal recommendation PCCs remain underused by many physicians who prefer to opt for fresh frozen plasma despite its limitations in anticoagulant reversal including time to reverse INR and high risk of transfusion-related acute lung injury. In contrast the lower volume required to normalise INR with PCCs and the room temperature storage facilitate faster preparation and administration time thus increasing the speed at which haemorrhages can be treated. PCCs therefore allow faster more reliable and complete reversal of vitamin K anticoagulation especially when administered immediately following confirmation of haemorrhage. In the emergency setting probabilistic dosing may be considered. Introduction Since the introduction of oral anticoagulants over 50 years ago there has been a dramatic increase in their use in the developed world due to their high success in preventing thromboembolic events. In fact

TÀI LIỆU LIÊN QUAN
TỪ KHÓA LIÊN QUAN
crossorigin="anonymous">
Đã phát hiện trình chặn quảng cáo AdBlock
Trang web này phụ thuộc vào doanh thu từ số lần hiển thị quảng cáo để tồn tại. Vui lòng tắt trình chặn quảng cáo của bạn hoặc tạm dừng tính năng chặn quảng cáo cho trang web này.