Надання невідкладної медичної допомоги пацієнтам, які отримують пероральні антикоагулянти, що не є антагоністами вітаміну К

J. W. Eikelboom, S. Kozek-Langenecker, A. Exadaktylos, A. Batorova, Z. Boda, F. Christory, I. Gornik, G. Kekstas, A. Kher, A. Komadina, O. Koval, G. Mitic, T. Novikova, E. Pazvanska, S. Ratobilska, J. Sutt, A. Winder, D. Zateyshchikov

Анотація


© 2017 Автор(и). Опубліковано видавництвом «Elsevier Ltd» від імені Британського журналу анестезії. Ця стаття знаходиться у відкритому доступі та розповсюджується за ліцензією CC BY-NC-ND (http://creativecommons.org/licenses/by-nc-nd/4.0/). Для отримання дозволу звертайтесь за електронною адресою: permissions@elsevier.com Пероральні антикоагулянти, що не є антагоністами вітаміну K (NOAC), які інгібують тромбін (дабігатран) та фактор Xa (рівароксабан, апіксабан, едоксабан) були впроваджені для використання за декількома клінічними показаннями. Хоча NOAC мають сприятливе співвідношення користь-ризик і можуть використовуватися без рутинного лабораторного моніторингу, як і інші антикоагулянти, вони асоціюються з ризиком кровотечі. Крім того, пацієнтам які потребують хірургічної операції або інших процедур, може знадобитись переривання лікування. Метою цієї статті, підготовленої міждисциплінарною групою фахівців з тромбозу та гемостазу, є оновлення стратегії лікування пацієнтів, які отримують NOAC, котрі зазнають кровотечі або потребують термінового втручання. Очікується, що останні досягнення в розробці таргетних препаратів зворотної дії допоможуть оптимізувати ведіння пацієнтів, які отримують NOAC, котрі потребують швидкого скасування антикоагулянтного ефекту

Ключові слова


антикоагулянти; моніторинг коагуляції; надзвичайні ситуації; крововилив; скасування ефекту

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DOI: https://doi.org/10.1016/j.bja.2017.11.082



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