Guideline for reversal of antithrombotics in intracranial hemorrhage: A statement for healthcare professionals from the Neurocritical Care Society and Society of Critical Care Medicine Journal Article
| Authors: | Frontera, J. A.; Lewin, J. J. 3rd; Rabinstein, A. A.; Aisiku, I. P.; Alexandrov, A. W.; Cook, A. M.; del Zoppo, G. J.; Kumar, M. A.; Peerschke, E. I. B.; Stiefel, M. F.; Teitelbaum, J. S.; Wartenberg, K. E.; Zerfoss, C. L. |
| Article Title: | Guideline for reversal of antithrombotics in intracranial hemorrhage: A statement for healthcare professionals from the Neurocritical Care Society and Society of Critical Care Medicine |
| Abstract: | Background: The use of antithrombotic agents, including anticoagulants, antiplatelet agents, and thrombolytics has increased over the last decade and is expected to continue to rise. Although antithrombotic-associated intracranial hemorrhage can be devastating, rapid reversal of coagulopathy may help limit hematoma expansion and improve outcomes. Methods: The Neurocritical Care Society, in conjunction with the Society of Critical Care Medicine, organized an international, multi-institutional committee with expertise in neurocritical care, neurology, neurosurgery, stroke, hematology, hemato-pathology, emergency medicine, pharmacy, nursing, and guideline development to evaluate the literature and develop an evidence-based practice guideline. Formalized literature searches were conducted, and studies meeting the criteria established by the committee were evaluated. Results: Utilizing the GRADE methodology, the committee developed recommendations for reversal of vitamin K antagonists, direct factor Xa antagonists, direct thrombin inhibitors, unfractionated heparin, low-molecular weight heparin, heparinoids, pentasaccharides, thrombolytics, and antiplatelet agents in the setting of intracranial hemorrhage. Conclusions: This guideline provides timely, evidence-based reversal strategies to assist practitioners in the care of patients with antithrombotic-associated intracranial hemorrhage. © 2015, Springer Science+Business Media New York. |
| Keywords: | drug tolerability; mortality; drug efficacy; drug safety; gastrointestinal hemorrhage; hypertension; nonhuman; outcome assessment; prospective study; sensitivity and specificity; unindexed drug; anemia; morbidity; prevalence; cohort analysis; evidence based practice; bradycardia; deep vein thrombosis; kidney failure; practice guideline; in vivo study; in vitro study; retrospective study; risk factor; lung embolism; cost effectiveness analysis; hypotension; prothrombin time; systematic review; clopidogrel; warfarin; unstable angina pectoris; blood transfusion; heparin; anticoagulation; observational study; risk reduction; anaphylaxis; hemodialysis; atrial fibrillation; brain hemorrhage; bioavailability; drug exposure; anticoagulant; heparin induced thrombocytopenia; enoxaparin; fondaparinux; lepirudin; partial thromboplastin time; venous thromboembolism; alteplase; anticoagulant agent; apixaban; argatroban; dalteparin; danaparoid; idraparinux; protamine sulfate; rivaroxaban; tinzaparin; blood clotting; pentasaccharide; randomized controlled trial (topic); cryoprecipitate; subarachnoid hemorrhage; phase 1 clinical trial (topic); guideline; recombinant blood clotting factor 7a; fresh frozen plasma; epidural hematoma; subdural hematoma; plasminogen activator; international normalized ratio; molecular size; hirulog; multicenter study (topic); aspirin; platelets; intracranial hemorrhage; rfviia; intracerebral hemorrhage; desmopressin; phytomenadione; protamine; prothrombin complex; retroperitoneal hemorrhage; thrombolytic; dabigatran; acenocoumarol; antidote; tpa; cerebral sinus thrombosis; dicoumarol; disseminated intravascular clotting; antithrombotic; direct thrombin inhibitor; continuous hemofiltration; ffp; factor xa inhibitor; blood clotting time; human; priority journal; article; dti; reversal; recombinant factor viia; prothrombin complex concentrates; activated prothrombin complex concentrates; antiplatelet; apcc; coumadin; ddavp; edoxaban; feiba; grade criteria; heparinoid; ich; intraparenchymal hemorrhage; low-molecular weight heparin; pcc; rtpa; sah; sdh; vitamin k antagonist; vka; activated carbon; andexanet alfa; ciraparantag; desulfatohirudin; idarucizumab; phenprocoumon; tecarfarin; bronchoconstriction; non st segment elevation myocardial infarction; non valvular atrial fibrillation; off pump coronary surgery |
| Journal Title: | Neurocritical Care |
| Volume: | 24 |
| Issue: | 1 |
| ISSN: | 1541-6933 |
| Publisher: | Springer |
| Date Published: | 2016-02-01 |
| Start Page: | 6 |
| End Page: | 46 |
| Language: | English |
| PROVIDER: | scopus |
| PUBMED: | 26714677 |
| DOI: | 10.1007/s12028-015-0222-x |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 March 2016 -- Source: Scopus |
