French clinical practice guidelines on the management of patients on vitamin K antagonists in at-risk situations (overdose, risk of bleeding, and active bleeding)

Pernod, Gilles; Godiér, Anne; Gozalo, Claire; Tremey, Benjamin; Sié, Pièrre

doi:10.1016/j.thromres.2010.06.017

Cited by 124 publications

(83 citation statements)

References 54 publications

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“…intracranial bleeding), causing haemodynamic instability or requiring an emergency surgical procedure or transfusion. 190 There are no data suggesting that the risk of thromboembolism due to transient reversal of anticoagulation outweighs the consequences of severe bleeding in patients with mechanical prostheses. The optimal time to restart anticoagulant therapy should be discussed in relation to the location of the bleeding event, its evolution and interventions performed to stop bleeding and/or to treat an underlying cause.…”

Section: Management Of Vitamin K Antagonist Overdose and Bleedingmentioning

confidence: 99%

2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

Baumgartner¹,

Falk²,

Bax³

et al. 2018

Revista Española de Cardiología (English Edition)

602

925

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Section: Management Of Vitamin K Antagonist Overdose and Bleedingmentioning

confidence: 99%

2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

Baumgartner¹,

Falk²,

Bax³

et al. 2018

Revista Española de Cardiología (English Edition)

602

925

View full text Add to dashboard Cite

“…Therefore, in patients with significant active bleeding known to be on VKAs, immediate administration of PCC (25 UI/Kg) is recommended even before INR results. PCC treatment will be subsequently adjusted according to INR results [23,24]. The F.C.S.A.…”

Section: Resultsmentioning

confidence: 99%

Prevention and treatment of trauma induced coagulopathy (TIC). An intended protocol from the Italian trauma update research group

Agostini¹,

Rondinelli²,

Bocci³

et al. 2013

J Anesthesiol Clin Sci

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In recent years, a strong focus has been put on the need to assure early coagulation support in order to prevent and treat coagulopathy in patients with severe trauma, and to improve survival. Aggressive plasma administration with high plasma/ red blood cells ratio is increasingly used worldwide. However, plasma transfusion is associated with increased risks of multiple organ dysfunction syndrome (MODS), adult respiratory distress syndrome (ARDS) and infection, which may prolong hospital stay and the need for artificial ventilation. Moreover, in the majority of European hospitals plasma cannot be immediately available and therefore it has been reported a significant delay in coagulation support. This has lead to the proposal of using clotting factors as an alternative to plasma. However, strong evidence to define the best strategy is still missing, and the only published protocols are Institution-specific, thus depending on the local organization and the available resources. The Italian Trauma Centers Network (TUN) recently developed a treatment protocol aiming at shortening the interval before the onset of coagulation support and at reducing the use of plasma. We present this protocol-Early Coagulation Support (ECS) Protocol -and discuss its rationale. Its implications for the trauma-team workflow and hospital organization are also addressed. The ECS protocol must be considered as an integrated part of a comprehensive Damage Control Strategy. The impact of the ECS Protocol on blood products consumption, trauma mortality and morbidity as well as its financial aspects, will be strictly monitored by the TUN hospitals.

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“…5 Recent French guidelines suggest restarting anticoagulation in such patients in 48-72 hours for large extracranial bleeds and one to two weeks for intracranial bleeds. 6 This applies to both traumatic and spontaneous bleeds in the context of a mechanical heart valve. Overall, it can be concluded that management of warfarin-induced major bleeding in patients with mechanical heart valves is challenging and needs to be tailored to different patients according to the clinical picture supported by relevant imaging at different stages.…”

Section: Discussionmentioning

confidence: 99%

54 Days Without Anticoagulation in a Patient with Metallic Mitral Valve

2015

Clinical Medicine Insights: Geriatrics

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French clinical practice guidelines on the management of patients on vitamin K antagonists in at-risk situations (overdose, risk of bleeding, and active bleeding)

Cited by 124 publications

References 54 publications

2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

2017 ESC/EACTS Guidelines for the Management of Valvular Heart Disease

Prevention and treatment of trauma induced coagulopathy (TIC). An intended protocol from the Italian trauma update research group

54 Days Without Anticoagulation in a Patient with Metallic Mitral Valve

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