American College of Surgeons’ Guidelines for the Perioperative Management of Antithrombotic Medication

Hornor, Melissa A.; Duane, Therèse M.; Ehlers, Anne P.; Jensen, Eric H.; Brown, Paul S.; Pohl, Dieter; Costa, Paulo; Ko, Clifford Y.; Laronga, Christine

doi:10.1016/j.jamcollsurg.2018.08.183

Cited by 104 publications

(79 citation statements)

References 85 publications

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“…Anticoagulants (Warfarin, DOACs, Heparin/Enoxaparin) Prothrombin complex concentrate (PCC) and fresh frozen plasma may be administered and titrated to the required effect in these cases [121,122]. Specific reversal agents exist for DOAC medications and can be used if available.…”

Section: Reversal Of Antithrombotic Medicationsmentioning

confidence: 99%

Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1—Preoperative: Diagnosis, Rapid Assessment and Optimization

et al. 2021

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Background Enhanced Recovery After Surgery (ERAS) protocols reduce length of stay, complications and costs for a large number of elective surgical procedures. A similar, structured approach appears to improve outcomes, including mortality, for patients undergoing high-risk emergency general surgery, and specifically emergency laparotomy. These are the first consensus guidelines for optimal care of these patients using an ERAS approach. Methods Experts in aspects of management of the high-risk and emergency general surgical patient were invited to contribute by the International ERAS® Society. Pubmed, Cochrane, Embase, and MEDLINE database searches on English language publications were performed for ERAS elements and relevant specific topics. Studies on each item were selected with particular attention to randomized controlled trials, systematic reviews, meta-analyses and large cohort studies, and reviewed and graded using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Recommendations were made on the best level of evidence, or extrapolation from studies on non-emergency patients when appropriate. The Delphi method was used to validate final recommendations. The guideline has been divided into two parts: Part 1—Preoperative Care and Part 2—Intraoperative and Postoperative management. This paper provides guidelines for Part 1. Results Twelve components of preoperative care were considered. Consensus was reached after three rounds. Conclusions These guidelines are based on the best available evidence for an ERAS approach to patients undergoing emergency laparotomy. Initial management is particularly important for patients with sepsis and physiological derangement. These guidelines should be used to improve outcomes for these high-risk patients.

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Section: Reversal Of Antithrombotic Medicationsmentioning

confidence: 99%

Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1—Preoperative: Diagnosis, Rapid Assessment and Optimization

et al. 2021

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“…When being used for secondary prevention of cardiovascular disease, David Keeling et al (23) recommended that if the perceived bleeding risk is high, aspirin can be omitted from day − 3 to day + 7 with no net detriment. The guidelines of the American College of Surgeons (24) suggest that if deemed safe by the operating surgeon, LMWH can be resumed 48-72 hours after high-risk bleeding surgery. They recommend holding aspirin (low/high dose) for 7-10 days before a high bleeding risk procedure in patients without a history of percutaneous coronary intervention, and aspirin should not be restarted until the operative bleeding risk is minimal.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Hemorrhage following Aspirin Administration in a Patient with Delayed Diagnosis of Kawasaki Disease

Tao

Gong

2021

Preprint

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Background: Kawasaki disease (KD) is an acute vasculitis of childhood, which has a typical coronary artery aneurysm complication. Cerebral arteries are usually spared from the disease process. Intracranial aneurysms and hemorrhage strokes are rarely reported.Case presentation: A 12-year-old boy presented with a sudden disturbance of consciousness caused by an intracranial aneurysm’s rupture. Through later clinical manifestations and echocardiography, we found that he had been in Kawasaki disease 20 days before the hospitalization.Conclusions: This case shows a close link between Kawasaki disease and cerebral aneurysm complication. It arouses more attention to applying aspirin appropriately in the perioperative intracranial surgery period of KD patients. For febrile patients with high-risk factors for KD, echocardiograms may be performed before day 5 of fever.

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“…Both ENG-IMP insertion and standard ENG-IMP removal are minor procedures with minimal risk of significant bleeding (similar to that associated with minor dermatological procedures, dental extraction and cardiac pacemaker implantation) 126,127. Local haemostasis is likely to be achieved by application of wound site pressure.…”

Section: Local Anaesthesia For Implant Insertion and Removal Procementioning

confidence: 99%

FSRH Guideline (February 2021) Progestogen-only Implant

2021

BMJ Sex Reprod Health

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American College of Surgeons’ Guidelines for the Perioperative Management of Antithrombotic Medication

Cited by 104 publications

References 85 publications

Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1—Preoperative: Diagnosis, Rapid Assessment and Optimization

Guidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations: Part 1—Preoperative: Diagnosis, Rapid Assessment and Optimization

Cerebral Hemorrhage following Aspirin Administration in a Patient with Delayed Diagnosis of Kawasaki Disease

FSRH Guideline (February 2021) Progestogen-only Implant

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