Markers of increased thrombin generation

Prisco, Domenico

doi:10.1007/bf02900706

Cited by 10 publications

References 45 publications

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Hemodialysis for removal of dabigatran in a patient with gastric hemorrhage

Kashiura

Fujita

Sugiyama

et al. 2015

Acute Medicine & Surgery

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Case: An 82-year-old man taking dabigatran was admitted with syncope. Computed tomography showed extravasation from the stomach. Laboratory data revealed renal insufficiency and prolonged activated partial thromboplastin time. The gastric endoscopy showed a gastric ulcer with an exposed vessel. However, an endoscopic hemostatic procedure failed to completely stop the bleeding. The patient experienced cardiac arrest from hypotensive shock. Spontaneous circulation returned after 5 min of resuscitation. After endoscopy, computed tomography showed a gastric perforation. For dabigatran removal, the patient underwent a 6-h hemodialysis session. Thrombin activity and thrombin-antithrombin complex increased during hemodialysis, while activated partial thromboplastin time decreased.Outcome: Good recovery was observed after dialysis and the following gastrectomy. Conclusion: Hemodialysis should be considered for dabigatran removal in cases of life-threatening hemorrhage. The thrombinantithrombin complex may be useful for monitoring the plasma dabigatran level.

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