• Charles-Marc Samama, Gilles Pernod, Pierre Albaladejo, Pierre Sie, and Groupe d’intérêt en hémostase péri-opératoire (GIHP).
• Groupe hospitalier Cochin-Broca-Hôtel-Dieu, service d'anesthésie-réanimation, 75014 Paris, France. Electronic address: marc.samama@cch.aphp.fr.
• Presse Med. 2014 Jun 1;43(6 Pt 1):637-44.

AbstractNew oral anticoagulants do represent a major step forward as compared to low molecular weight heparins and vitamin K antagonists. Several issues deserve attention regarding their perioperative management. Three (and very soon four or five) active molecules are available on the market, adding to the major intra- and inter-individual variability, to the high number of drug-drug interactions, and to the interferences of renal function and many other parameters. New tests are available including the diluted thrombin time for dabigatran and a specific anti-Xa test for rivaroxaban and apixaban. No antidote is approved yet. Scheduled surgery: the safest suggestion is to mimic the perioperative management of vitamin K antagonist, with a 5-day interruption and low molecular weight heparin bridging whenever necessary. Emergency procedures: several suggestions issued from the Groupe d'Intérêt en Hémostase Péri-opératoire are proposed.Copyright © 2014 Elsevier Masson SAS. All rights reserved.

22 keywords...

hide…