Bed rest does not induce hypercoagulability

Cvirn, Gerhard; Waha, James Elvis; Ledinski, Gerhard; Schlagenhauf, Axel; Leschnik, B.; Koestenberger, Martin; Tafeit, Erwin; Hinghofer‐Szalkay, Helmut; Goswami, Nandu

doi:10.1111/eci.12383

Cited by 33 publications

(41 citation statements)

References 24 publications

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“…Prolonged bed rest in healthy volunteers does not induce a hypercoagulability state [40], however this is not generalizable to the perioperative context and caution should be advised if prolonged immobilization is required post-surgery.…”

Section: Perioperative Management Of Doacsmentioning

confidence: 99%

Perioperative management of patients on direct oral anticoagulants

et al. 2017

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Direct oral anticoagulants (DOACs) have been licensed worldwide for several years for various indications. Each year, 10–15% of patients on oral anticoagulants will undergo an invasive procedure and expert groups have issued several guidelines on perioperative management in such situations. The perioperative guidelines have undergone numerous updates as clinical experience of emergency management has increased and perioperative studies including measurement of residual anticoagulant levels have been published. The high inter-patient variability of DOAC plasma levels has challenged the traditional recommendation that perioperative DOAC interruption should be based only on the elimination half-life of DOACs, especially before invasive procedures carrying a high risk of bleeding. Furthermore, recent publications have highlighted the potential danger of heparin bridging use when DOACs are stopped before an invasive procedure.As antidotes are progressively becoming available to manage severe bleeding or urgent procedures in patients on DOACs, accurate laboratory tests have become the standard to guide their administration and their actions need to be well understood by clinicians.This review aims to provide a systematic approach to managing patients on DOACs, based on recent updates of various perioperative guidance, and highlighting the advantages and limits of recommendations based on pharmacokinetic properties and laboratory tests.

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Section: Perioperative Management Of Doacsmentioning

confidence: 99%

Perioperative management of patients on direct oral anticoagulants

et al. 2017

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“…Bedrest immobilization is routinely used to simulate physiological deconditioning including that of the cardiovascular system (see [11]). Whilst adrenomedullin and galanin have been investigated with regard to acute orthostatic intolerance, their potential role in the reduced orthostatic intolerance following bed rest has yet to be determined.…”

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confidence: 99%