Austrian recommendations for best clinical practice in case of haemorrhagic traumatic brain injury under platelet inhibitors or non-vitamin K antagonist oral anticoagulants: an additional therapeutic option to consider

The drug is widely available and its cost is acceptable. [...]idarucizumab clearly represents the therapy of choice in dabigatran-related bleeding. A current meta-analysis revealed that prothrombin complex concentrate (PCC) showed comparable haemostatic efficacy to andexanet alfa, but PCC is current...

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Published in:Critical care (London, England) England), 2020-05, Vol.24 (1), p.204-204, Article 204
Main Authors: Honore, Patrick M, Mugisha, Aude, Kugener, Luc, Redant, Sebastien, Attou, Rachid, Gallerani, Andrea, De Bels, David
Format: Article
Language:English
Subjects:
Anticoagulants
Blood platelets
Brain injuries
Critical care
Idarucizumab
Interdisciplinary aspects
Letter
Ticagrelor
Traumatic brain injury
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Summary:The drug is widely available and its cost is acceptable. [...]idarucizumab clearly represents the therapy of choice in dabigatran-related bleeding. A current meta-analysis revealed that prothrombin complex concentrate (PCC) showed comparable haemostatic efficacy to andexanet alfa, but PCC is currently not approved for Xa-inhibitor reversal [7]. [...]before suggesting CHP in bleeding TBI patients, we would highly recommend PCC as a more rapid, widely available, and less invasive alternative for Xa-inhibitor reversal compared to CHP. For bleeding patients under NOACs, a variety of specific and unspecific reversal agents are available. [...]before recommending an invasive procedure such as CHP in TBI patients, both safety and efficacy have to be confirmed in vivo.
ISSN:1364-8535
1466-609X
1364-8535
1366-609X
DOI:10.1186/s13054-020-02922-6