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- Brian W Gilbert, Tori R Adams, Tessa R Reynolds, David A Moran, and George J Philip.
- Wesley Medical Center, Department of Pharmacy, 550 N. Hillside Ave, Wichita, KS 67214, United States of America. Electronic address: brian.gilbert@wesleymc.com.
- Am J Emerg Med. 2019 Oct 1; 37 (10): 1991.e1-1991.e3.
AbstractReversal of oral factor Xa (FXa) inhibitors, such as apixaban, remains a controversial topic. However, the controversy goes beyond what reversal agent to utilize. Often times these patients present with an acute major bleed and are difficult to assess whether reversal is warranted or not. Furthermore, it is difficult to assess whether reversal was successful in a timely manner. A paucity of literature exists regarding the utilization of low molecular weight heparin (LMWH) anti-Xa assays and thromboelastography for identifying coagulopathies associated with oral FXa inhibitors. We report a case of apixaban induced coagulopathy utilizing thromboelastography and a LMWH anti-Xa assay as a guide for reversal.Copyright © 2019 Elsevier Inc. All rights reserved.
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