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- Michal Bar-Natan and Kenneth B Hymes.
- Division of Hematology and Oncology, Department of Internal Medicine, Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine, 240 East 38th Street, 19th Floor, New York, NY 10016, USA.
- Neurosurg. Clin. N. Am. 2018 Oct 1; 29 (4): 557-565.
AbstractIntraoperative bleeding can be minimized with optimal preoperative preparation but cannot be completely prevented. There are circumstances when patients need emergent operative intervention, and thorough hemostatic evaluation and preparation is not possible. In this review, the authors summarize the recommendations for rapid reversal of vitamin K antagonists and direct oral anticoagulants before procedures. The authors review the potential causes for intraoperative bleeding and the methods for rapid and accurate diagnosis. The authors summarize the current evidence for treatment options, including transfusion of platelets and coagulation factors and the use of topical agents, antidotes to direct-acting anticoagulants, antifibrinolytics, and desmopressin.Copyright © 2018 Elsevier Inc. All rights reserved.
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