Anticoagulant Reversal in Gastrointestinal Bleeding: Review of Treatment Guidelines

Milling, Truman J.; Refaai, Majed A.; Sengupta, Neil

doi:10.1007/s10620-020-06728-y

Cited by 12 publications

(12 citation statements)

References 81 publications

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“…[2] Criteria for rebleeding: one of the following conditions occurs after the first successful hemostasis treatment: hematemesis, melena/hematochezia, the stomach tube sucks out fresh blood, hemodynamic instability (systolic blood pressure < 100 mmHg, heart rate > 100 beats/ min, hemoglobin decrease > 20 g/L), and rebleeding was confirmed under endoscopy. [3] Criteria for the effectiveness of endoscopic treatment: the first endoscopic treatment was successful and there was no further bleeding within 3 days (Table 1).…”

Section: Efficacy Evaluation Criteriamentioning

confidence: 99%

“…It is a common acute and critical disease of the digestive system, with rapid onset, rapid progress, dangerous condition, and high fatality rate [2]. Therefore, the diagnosis and treatment of ANVUGIB is still a hot spot in clinical research at home and abroad [3]. Includes statistical analysis of the etiological composition, changing patterns, timing and endoscopic treatment methods of ANVUGIB in the region.…”

Section: Introductionmentioning

confidence: 99%

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A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding

Nian

Wang

et al. 2022

Applied Bionics and Biomechanics

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Objective. The aim of this study was to better understand the characteristics and etiology of acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) in recent years in this region and to provide evidence-based medical evidence. Methods. 100 patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) who met the clinical diagnostic criteria of ANVUGIB admitted to Suzhou First People’s Hospital from January 2017 to December 2021 were analyzed, as well as the age difference and change rule. According to age, 100 patients were divided into young (18-39 years), middle-aged (40-59 years), and elderly (60 years and above), and the differences in the three groups were compared. The etiology was confirmed by endoscopic examination and was recorded one by one in a well-designed ANVUGIB case data registration form. Statistical software SPSS 23.0 was used for analysis. Results. Gastric ulcer was the main cause in the elderly group (50.0%), duodenal ulcer was the main cause in the middle and young groups, and gastrointestinal cancer (7.1%) and marginal ulcer (2.3%) in the elderly group were higher than those in the young group. Nonsteroidal anti-inflammatory drugs (52.3%) were the main inducement in the elderly group, which was significantly higher than in the middle-aged group (13.1%) and the young group (5%) ( P < 0.01 ). Drinking, fatigue, and emotional excitement led to a higher proportion in the middle-aged group and the young group, in comparison to the elderly group ( P < 0.01 ). Conclusion. Peptic ulcer is the most common cause of acute nonvariceal upper gastrointestinal bleeding, followed by acute gastric mucosal lesions and upper digestive system tumors, compared with nonulcer.

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Section: Efficacy Evaluation Criteriamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding

Nian

Wang

et al. 2022

Applied Bionics and Biomechanics

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“…Liver ultrasound: debris with a thick wall and/or a distal acoustic enhancement in at least one cyst Liver CT/MRI: enhanced wall thickening and/or perilesional inflammation in at least one cyst MRI: high signal intensity on diffusion-weighted images, fluid-fluid level, wall thickening, or gas in at least one cyst Positron emission tomography scan ( 18 FDG PET-CT): increased FDG activity lining a cyst compared to normal parenchyma onset of haemorrhage may best balance the risk of recurrent haemorrhage, and thromboembolism. 115,116 Given the non-life threatening nature of cyst bleeding, anticoagulants may be restarted earlier in cases with high risks for thromboembolisms. It seems reasonable to assume that the risks and benefits of resuming newer direct oral anticoagulants are largely similar to those of vitamin K antagonists in view of similar efficacy and safety in clinical trials.…”

Section: Radiological Findings Suggestive Of Hepatic Cyst Infectionmentioning

confidence: 99%

EASL Clinical Practice Guidelines on the management of cystic liver diseases

Drenth¹,

Barten²,

Hartog³

et al. 2022

Journal of Hepatology

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“…For those already on anticoagulation and presenting with bleed, the indications for reversal can be determined based off of the type of anticoagulation regimen the patient is on [ 10 ]. Per the American College of Gastroenterology and the Canadian Association of Gastroenterology Clinical Practice Guidelines, those on warfarin should be given prothrombin complex concentrate (PCC) as opposed to vitamin K and FFP.…”

Section: Discussionmentioning

confidence: 99%

To Bleed or Not to Bleed

Iskander¹,

Zaidi²,

Zheng³

et al. 2023

Cureus

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The location of gastrointestinal (GI) bleeding can be characterized based on the characteristics of the bowel movements these patients present with. Bright red blood per rectum is usually associated with a lower bleed; if brisk and significant enough, however, upper bleeds can present similarly. Melenic or "tar-colored" bowel movements are more likely to occur from upper bleeds as the color is secondary to digestion of hemoglobin as it passes through the GI tract. At times, there can be a mix of the two which can make a clinical decision for intervention less obvious. To make matters more difficult, some of these patients can be on anticoagulation therapy for a myriad of reasons. Risks versus benefits at these times need to be weighed as holding this therapy may make the patients more prone to clotting while continuation would increase likelihood of bleeding. We present a case of a hypercoagulable patient who was started on rivaroxaban for history of pulmonary embolism; this led to the onset of an acute GI bleed from a duodenal diverticulum requiring endoscopic intervention. Although this can be a known effect of the therapy, the severity of bleed and changes in hemodynamics can warrant very different management strategies.

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Anticoagulant Reversal in Gastrointestinal Bleeding: Review of Treatment Guidelines

Cited by 12 publications

References 81 publications

A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding

A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding

EASL Clinical Practice Guidelines on the management of cystic liver diseases

To Bleed or Not to Bleed

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