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. 2023 Jul;126(7):559-562.
doi: 10.1007/s00113-023-01310-3. Epub 2023 Mar 28.

[Treatment of a severely injured with active bleeding under apixaban and residual anticoagulatory activity]

[Article in German]
Marc Maegele  1   2 , Benedikt Stolz  3 , Stefan Trojan  4 , Igor Lazarevits  4 , Martin Linde  4 , Jürgen Meyer-Zillekens  5 , Mathias Formesyn  5 , Eliza von der Leyen  4 , Ulrich Limper  4   6
Affiliations

[Treatment of a severely injured with active bleeding under apixaban and residual anticoagulatory activity]

[Article in German]
Marc Maegele et al. Unfallchirurgie (Heidelb). 2023 Jul.

Abstract
in English, German

Direct oral anticoagulants (DOAC) are increasingly being prescribed for prophylaxis of thromboembolic events. Their use, particularly in emergency settings is difficult as blood level measurements are often not immediately available and until recently there was no possibility for reversal. This article presents the case of a severely injured patient with life-threatening traumatic bleeding under long-term treatment with the factor Xa inhibitor apixaban, viscoelasticity-based detection of residual systemic anticoagulatory activity and targeted reversal.

Direkte orale Antikoagulanzien (DOAK) werden zunehmend zur Prophylaxe thrombembolischer Ereignisse eingesetzt. Ihr Umgang, insbesondere in Notfallsituationen, gestaltet sich schwierig, da Spiegelmessungen oft nicht zeitnah zur Verfügung stehen und bis vor Kurzem keine Möglichkeit zur Antagonisierung bestand. Es wird die notfallmäßige Behandlung eines Schwerstmehrfachverletzten mit lebensbedrohlicher traumatischer Blutung unter Dauertherapie mit dem Faktor-Xa-Hemmer Apixaban, viskoelastizitätsbasierter Detektion gerinnungsrelevanter Restaktivität bei Schockraumaufnahme und gezielter Wirkungsaufhebung beschrieben.

Keywords: Bleeding; DOAC; Diagnostics; Reversal; Trauma.

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References

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