Search our Database of Scientific Publications and Authors

I’m looking for a

    573 results match your criteria Perioperative Anticoagulation Management

    1 OF 12

    A simultaneous minimally invasive approach to treat a patient with coronary artery disease and metastatic lung cancer.
    Wideochir Inne Tech Maloinwazyjne 2016 29;11(4):300-303. Epub 2016 Nov 29.
    People's Hospital of Ganzhou, Nanchang University, Ganzhou, China.
    Concurrent lung cancer and coronary artery disease requiring treatment with percutaneous coronary intervention or coronary artery bypass grafting is not rare. An individualized perioperative anticoagulation regimen and minimal surgical trauma will benefit the patient's postoperative recovery. We successfully treated a 68-year-old female patient with a lesion in the left anterior descending artery and metastatic right lung carcinoma by simultaneous minimally invasive direct coronary artery bypass grafting via a small left thoracotomy and thoracoscopic wedge resection of the lung lesion. Read More

    [A Case of Thyroid Carcinoma in Consideration for Perioperative Management].
    Gan To Kagaku Ryoho 2016 Nov;43(12):2124-2126
    Division of Breast and Endocrine Surgery, Dept. of Surgery, Nihon University School of Medicine.
    When patients are on long-term dialysis, various kinds of medication are given. We report our experience with a 75-yearold woman with thyroid carcinoma incidentally discovered during dialysis. Ultrasonography of the thyroid showed a tumor of about 3 cm in the right lobe center. Read More

    Coagulation Management in Jersey Calves: An ex vivo Study.
    Eur Surg Res 2017 Jan 27;58(3-4):128-139. Epub 2017 Jan 27.
    Department of Anaesthesiology, RWTH Aachen University Hospital, Aachen, Germany.
    Objective: Jersey calves are frequently used as an experimental animal model for in vivo testing of cardiac assist devices or orthopedic implants. In this ex vivo study, we analyzed the coagulation system of the Jersey calves and the potential of human-based coagulation management to circumvent perioperative bleeding complications during surgery. Experimental Procedure: Blood from 7 Jersey calves was subjected to standard laboratory tests and thromboelastometry analysis. Read More

    Perioperative Management of Direct Oral Anticoagulants (DOACs): A Systemic Review.
    Health Serv Insights 2016 13;9(Suppl 1):25-36. Epub 2016 Dec 13.
    Division of Gastroenterology, The Brooklyn Hospital Center, Brooklyn, NY, USA.
    Direct oral anticoagulants (DOACs) are in wide use among patients requiring both short- and long-term anticoagulation, mainly due to their ease of use and the lack of monitoring requirements. With growing use of DOACs, it is imperative that physicians be able to manage patients on these medications, especially in the perioperative period. We aim to provide guidance on the management of DOACs in the perioperative period. Read More

    [Perioperative patient management in orthogeriatrics].
    Orthopade 2017 Jan;46(1):54-62
    Klinik für Anästhesiologie und Intensivmedizin, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland.
    The management of major orthopedic surgery in the elderly prototypically reflects the perioperative risks of geriatric, often very frail patients reflecting an aging population. To improve outcome, the risks of anesthesia and surgery as well as of patient comorbidities must be thoroughly assessed and balanced using a multidisciplinary approach. Particular risks include cardiopulmonary morbidity, anemia, risk of hemorrhage and the management by anticoagulation, cerebral impairments as well as frailty and limited physiological reserves in general. Read More

    Healthcare resource utilization in patients receiving idarucizumab for reversal of dabigatran anticoagulation due to major bleeding, urgent surgery, or procedural interventions: interim results from the RE-VERSE AD™ study.
    J Med Econ 2017 Jan 17:1-8. Epub 2017 Jan 17.
    l McMaster University and Thrombosis and Atherosclerosis Research Institute , Hamilton , Ontario , Canada.
    Aims: Patients treated with anticoagulants may experience serious bleeding or require urgent surgery or intervention, and may benefit from rapid anticoagulant reversal. This exploratory analysis assessed healthcare resource utilization (HCRU) in patients treated with idarucizumab, a specific reversal agent for dabigatran etexilate.

    Materials And Methods: RE-VERSE AD™ (NCT02104947), a prospective, multi-center open-label study, is evaluating idarucizumab for dabigatran reversal in patients with serious bleeding (Group A) or undergoing emergency surgery/procedures (Group B). Read More

    Periprocedural Management of Non-Vitamin K Oral Anticoagulants in Chronic Kidney Disease: A Review of Existing Heterogeneity and Contemporary Evidence.
    J Atr Fibrillation 2015 Dec 31;8(4):1230. Epub 2015 Dec 31.
    Chief and Director, Division of Cardiology and Cardiac Catheterization Laboratory, Heartland Veterans Affairs Medical Center, Kansas City, MO, USA.
    Non vitamin-K oral anticoagulants (NOAC) have considerably enhanced anticoagulation practice for non-valvular atrial fibrillation with specific advantages of fixed dosing, non-fluctuant therapeutic levels and obviation of therapeutic level monitoring. NOAC pharmacology is remarkable for considerable renal excretion. Heterogeneity in the precise time cut-offs for discontinuation of NOACs prior to elective surgical or percutaneous procedures arise from the non-linear variations of drug excretion with different levels of creatinine clearances as in chronic kidney disease. Read More

    Perioperative management of adult patients with a history of stroke or transient ischaemic attack undergoing elective non-cardiac surgery.
    Clin Med (Lond) 2016 Dec;16(6):535-540
    Department of Ageing and Health, St Thomas' Hospital, London, UK.
    It is increasingly common for physicians and anaesthetists to be asked for advice in the medical management of surgical patients who have an incidental history of stroke or transient ischaemic attack (TIA). Advising clinicians requires an understanding of the common predictors, outcomes and management of perioperative stroke. The most important predictor of perioperative stroke is a previous history of stroke, and outcomes associated with such an event are extremely poor. Read More

    Current Management in Transurethral Therapy of Benign Prostatic Obstruction in Patients on Oral Anticoagulation: A Worldwide Questionnaire.
    J Endourol 2017 Feb 5;31(2):163-168. Epub 2017 Jan 5.
    Department of Urology, Asklepios Hospital Barmbek , Hamburg, Germany .
    Objective: To assess the current treatment of benign prostatic obstruction (BPO) in patients on ongoing oral anticoagulation (OA).

    Methods: An Internet survey was sent to all active members of the Endourological Society. The survey contained 32 questions regarding transurethral treatment of BPO in patients on ongoing OA, different techniques, and arising complications. Read More

    Perioperative Pharmacological Thromboprophylaxis in Patients With Cancer: A Systematic Review and Meta-analysis.
    Ann Surg 2016 Nov 15. Epub 2016 Nov 15.
    Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu , Sichuan Province, China.
    Objective: To compare the relative effects between pharmacological thromboprophylaxis and no anticoagulation.

    Background: The efficacy and safety of pharmacological thromboprophylaxis in cancer patients undergoing surgery need to be quantified to guide management.

    Methods: We searched multiple electronic databases (up to March 31, 2016) for trials of cancer patients undergoing surgery that assessed the relative benefits and harms of perioperative pharmacological thromboprophylaxis. Read More

    Factors Associated with Patient-Initiated Telephone Calls After Spine Surgery.
    World Neurosurg 2016 Nov 9. Epub 2016 Nov 9.
    Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA. Electronic address:
    Background: Telephone calls play a significant role in the follow-up care of postoperative patients. However, further data is needed to identify the determinants of patient-initiated telephone calls following surgery as these factors may also highlight potential areas of improvement in patient satisfaction and during the hospital discharge process. Thus, the goal of this study is to determine the number of postoperative patient telephone calls within 14 days following surgery and establish the factors associated with patient-initiated calls as well as reasons for calling. Read More

    Rivaroxaban for Periprocedural Anticoagulation Therapy in Japanese Patients Undergoing Catheter Ablation of Paroxysmal Non-Valvular Atrial Fibrillation.
    Int Heart J 2016 Dec 4;57(6):712-716. Epub 2016 Nov 4.
    Heart Rhythm Center, Tokyo Medical and Dental University.
    Direct oral anticoagulants (DOACs) have been shown to be safe and effective for the prevention of stroke in nonvalvular atrial fibrillation (NVAF) patients, however, experience with peri-AF ablation management of DOACs is scarce. This study aimed to investigate the safety and feasibility of periprocedural anticoagulation therapy with rivaroxaban in Japanese patients undergoing paroxysmal non-valvular AF (NVAF) ablation using radiofrequency energy.This study was a multicenter, prospective pilot study. Read More

    Coexisting Cardiac and Hematologic Disorders.
    Anesthesiol Clin 2016 Dec;34(4):659-668
    Department of Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, USA.
    Patients with concomitant cardiac and hematologic disorders presenting for noncardiac surgery are challenging. Anemic patients with cardiac disease should be approached in a methodical fashion. Transfusion triggers and target should be based on underlying symptomatology. Read More

    Administration of Coagulation-Altering Therapy in the Patient Presenting for Oral Health and Maxillofacial Surgery.
    Oral Maxillofac Surg Clin North Am 2016 Nov;28(4):443-460
    Department of Anesthesiology, Yale University School of Medicine, 333 Cedar Street, TMP 3 Library, New Haven, CT 203 785-2804, USA. Electronic address:
    Oral health care providers are concerned with how to manage patients prescribed coagulation-altering therapy during the perioperative/periprocedural period for dental and oral surgery interventions. Management and recommendation can be based on medication pharmacology and the clinical relevance of coagulation factor levels/deficiencies. Caution should be used with concurrent use of medications that affect other components of the clotting mechanisms; prompt diagnosis and any necessary intervention to optimize outcome is warranted. Read More

    Best practice for perioperative management of patients with cytoreductive surgery and HIPEC.
    Eur J Surg Oncol 2016 Sep 28. Epub 2016 Sep 28.
    Department for General- and Visceral Surgery, Hospital Barmherzige Brüder, Regensburg, Germany.
    Due to the significantly improved outcome and quality of life of patients with different tumor entities after cytoreductive surgery (CRS) and HIPEC, there is an increasing number of centers performing CRS and HIPEC procedures. As this procedure is technically challenging with potential high morbidity and mortality, respectively, institutional experience also in the anesthetic and intensive care departments is essential for optimal treatment and prevention of adverse events. Clinical pathways have to be developed to achieve also good results in more comorbid patients with border line indications and extensive surgical procedures. Read More

    Update in perioperative cardiac medicine.
    Cleve Clin J Med 2016 Oct;83(10):723-730
    Professor of Medicine, Harvard Medical School, Boston, MA, USA.
    Recent studies have shed light on preoperative risk assessment, medical therapy to reduce postoperative cardiac complications (beta-blockers, statins, and angiotensin II receptor blockers [ARBs]), perioperative management of patients with coronary stents on antiplatelet therapy, and perioperative bridging anticoagulation. Read More

    Risk stratification, perioperative and periprocedural management of the patient receiving anticoagulant therapy.
    J Clin Anesth 2016 Nov 18;34:586-99. Epub 2016 Jul 18.
    Yale University School of Medicine, New Haven, CT.
    As a result of the aging US population and the subsequent increase in the prevalence of coronary disease and atrial fibrillation, therapeutic use of anticoagulants has increased. Perioperative and periprocedural management of anticoagulated patients has become routine for anesthesiologists, who frequently mediate communication between the prescribing physician and the surgeon and assess the risks of both thromboembolic complications and hemorrhage. Data from randomized clinical trials on perioperative management of antithrombotic therapy are lacking. Read More

    Management of direct oral anticoagulants in patients undergoing elective surgeries and invasive procedures: Updated guidelines from the French Working Group on Perioperative Hemostasis (GIHP) - September 2015.
    Anaesth Crit Care Pain Med 2016 Sep 20. Epub 2016 Sep 20.
    Department of Hematology and Transfusion, Lille University Hospital, Institut Pasteur de Lille, EGID, INSERM UMR 1011, University of Lille 2, Lille, France.
    Since 2011, data on patients exposed to direct oral anticoagulants (DOAs) while undergoing invasive procedures have accumulated. At the same time, an increased hemorrhagic risk during perioperative bridging anticoagulation without thrombotic risk reduction has been demonstrated. This has led the GIHP to update their guidelines published in 2011. Read More

    Anticoagulation management during cross-clamping and bypass.
    Best Pract Res Clin Anaesthesiol 2016 Sep 27;30(3):359-70. Epub 2016 Jul 27.
    Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA. Electronic address:
    Anticoagulation is required for successful implementation of cardiopulmonary bypass (CPB), as well as for surgeries requiring temporary aortic occlusion. It is well established that both coagulation and fibrinolysis are activated during CPB (Teufelsbauer et al., 1992) [1]. Read More

    Perioperative Management of the Direct Oral Anticoagulants: A Case-Based Review.
    Hematol Oncol Clin North Am 2016 Oct;30(5):1073-84
    Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, St. Joseph's Hospital, 50 Charlton Avenue East, Room F-544, Hamilton, ON L8N 4A6, Canada.
    The periprocedural management of patients on direct oral anticoagulants (DOACs) is a common but potentially challenging clinical problem because there are few prospective studies to guide clinical decisions. Retrospective analyses from randomized trials and observational data suggest that DOACs can be managed in a standardized manner, based on surgical and patient characteristics, that does not result in excess major bleeding or thrombosis. In a case-based manner, this article presents a perioperative DOAC management algorithm and reviews the available and emerging evidence supporting the safety and efficacy of this approach. Read More

    [2016 review on catastrophic antiphospholipid syndrome].
    Presse Med 2016 Dec 9;45(12 Pt 1):1084-1092. Epub 2016 Sep 9.
    Assistance publique-Hôpitaux de Paris, université Pierre-et-Marie-Curie, hôpital Pitié-Salpêtrière, centre de référence national pour le lupus systémique et le syndrome des antiphospholipides, département de médecine interne et d'immunologie clinique, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France.
    The catastrophic antiphospholipid syndrome (CAPS) develops in at least 1% of patients with antiphospholipid syndrome, either primary or associated with systemic lupus erythematosus. CAPS reveals the antiphospholipid syndrome in about 50% of cases. The CAPS is characterized by rapidly-progressive widespread thromboses mainly affecting the microvasculature in the presence of antiphospholipid antibodies. Read More

    2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation.
    Can J Cardiol 2016 Oct 6;32(10):1170-1185. Epub 2016 Sep 6.
    Southlake Regional Health Centre, Newmarket, Ontario, Canada.
    The Canadian Cardiovascular Society (CCS) Atrial Fibrillation (AF) Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in AF management. This 2016 Focused Update deals with: (1) the management of antithrombotic therapy for AF patients in the context of the various clinical presentations of coronary artery disease; (2) real-life data with non-vitamin K antagonist oral anticoagulants; (3) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (4) digoxin as a rate control agent; (5) perioperative anticoagulation management; and (6) AF surgical therapy including the prevention and treatment of AF after cardiac surgery. The recommendations were developed with the same methodology used for the initial 2010 guidelines and the 2012 and 2014 Focused Updates. Read More

    Venous Thromboembolism in Patients with High-Grade Glioma.
    Semin Thromb Hemost 2016 Nov 30;42(8):877-883. Epub 2016 Aug 30.
    Department of Neurosurgery, Cushing Neurosurgical Outcomes Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
    Venous thromboembolism (VTE), incorporating both deep vein thrombosis and pulmonary embolism, is a common, morbid, and potentially fatal condition. Patients undergoing surgery are at increased risk of VTE due to many perioperative factors, and patients undergoing surgery for high-grade glioma (HGG) have been found to be at an even higher risk than general surgical patients. Chemical prophylaxis of VTE during the postneurosurgical period remains one of the major dilemmas in modern neurosurgical practice due to a potential increased risk of devastating intracranial hemorrhage in the setting of anticoagulation. Read More

    Bivalirudin anticoagulation for minimal invasive transapical transcatheter aortic valve replacement in a patient with antiphospholipid antibodies.
    J Clin Anesth 2016 Sep 2;33:373-5. Epub 2016 Jun 2.
    Institute for Laboratory and Transfusion Medicine, Heart and Diabetes Center NRW, Bad Oeynhausen, Ruhr-University Bochum, Germany.
    The occurrence of lupus anticoagulant is associated with the hazard of developing an antiphospholipid syndrome, a severe prothrombotic condition which may particularly occur after major surgical trauma. This disease requires certain considerations regarding surgical strategy and anticoagulation management. We describe the perioperative management of a patient scheduled for elective aortic valve replacement and diagnosed for having antiphospholipid antibodies. Read More

    Silent pulmonary thromboembolism in neurosurgery patients: Report of 2 cases and literature review.
    Medicine (Baltimore) 2016 Aug;95(33):e4589
    Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
    Background: The requirement of postoperative bedridden and immobilization renders neurosurgical patients with higher risk of deep vein thrombosis (DVT), then more vulnerable for pulmonary thromboembolism (PTE). But silent pulmonary thromboembolism (SPTE) can be the very early stage of any typical form of PTE, its diagnosis and management is therefore critical in neurosurgical departments. However, to date, perioperative SPTE has not been attached with enough attention. Read More

    Ventricular Assist Devices in Pediatric Cardiac Intensive Care.
    Pediatr Crit Care Med 2016 Aug;17(8 Suppl 1):S160-70
    All authors: Department of Pediatrics, Section of Cardiology, Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
    Objectives: The objectives of this review are to discuss the process of patient and mechanical device selection, operative management, and postoperative care with a focus on the management of right ventricular failure, anticoagulation strategies, device-related infections and neurologic sequelae.

    Data Sources: MEDLINE, PubMed.

    Conclusion: The number of patients with advanced heart failure due to either acquired or congenital heart disease continues to increase, necessitating in some mechanical circulatory support and in others cardiac transplantation. Read More

    Ablation protocols and ancillary procedures in tumor ablation therapy: consensus from Japanese experts.
    Jpn J Radiol 2016 Sep 23;34(9):647-56. Epub 2016 Jul 23.
    Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
    Purpose: A panel of Japanese experts on tumor ablation therapy gathered to reach a general consensus on topics surrounding ablation therapy.

    Materials And Methods: Questionnaires relating to ablation protocols for radiofrequency ablation (RFA) and cryoablation, as well as ancillary procedures required for safe and secure ablation therapy, were sent to seven institutions. Experts from these institutions discussed each topic based on the evidence and the questionnaire data, and a consensus was reached at an annual meeting of the Japan Image-guided Ablation Group in Maebashi, Japan, in October 2015. Read More

    Influence of periprocedural anticoagulation strategies on complication rate and hospital stay in patients undergoing catheter ablation for persistent atrial fibrillation.
    Clin Res Cardiol 2017 Jan 19;106(1):38-48. Epub 2016 Jul 19.
    Department of Cardiology-Electrophysiology, University Heart Center Hamburg, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20251, Hamburg, Germany.
    Background: The use of non-vitamin K antagonists (NOACs), uninterrupted (uVKA) and interrupted vitamin K antagonists (iVKA) are common periprocedural oral anticoagulation (OAC) strategies for atrial fibrillation (AF) ablation. Comparative data on complication rates resulting from OAC strategies for solely persistent AF (persAF) undergoing ablation are sparse. Thus, we sought to determine the impact of these OAC strategies on complication rates among patients with persAF undergoing catheter ablation. Read More

    Postoperative Controversies in the Management of Free Flap Surgery in the Head and Neck.
    Facial Plast Surg Clin North Am 2016 Aug 24;24(3):309-14. Epub 2016 May 24.
    Department of Otolaryngology, Oregon Health Sciences University, Portland, OR 97239, USA.
    Free tissue transfer is the gold standard for reconstructing head and neck defects. Free flap success approaches 95% in centers with experience, affording unparalleled ability to restore form and function in cancer, trauma, or other major composite tissue loss. It is critical to manage the perioperative variables that predict success; several areas of controversy have not yet reached consensus. Read More

    Update in perioperative medicine: practice-changing evidence published in 2015.
    Hosp Pract (1995) 2016 Aug 25;44(3):157-63. Epub 2016 Jul 25.
    a Division of General Internal Medicine, Department of Medicine , Mayo Clinic and Mayo Clinic College of Medicine , Rochester , MN , USA.
    Evidence in perioperative medicine is published in a wide variety of journals, given the multidisciplinary nature of its practice which spans medicine and its subspecialties, as well as surgery and anesthesiology. It can be difficult to identify new and important evidence, as perioperative practice continues to evolve in multiple areas such as medication management, anticoagulation and cardiac risk stratification, among others. New, high-quality evidence is published each year, and must be placed into the context of not only existing literature, but also practical real-world patient care. Read More

    Use of direct oral anticoagulants with regional anesthesia in orthopedic patients.
    J Clin Anesth 2016 Aug 22;32:224-35. Epub 2016 Apr 22.
    Anaesthesia and Intensive Care Unit, Policlinico S. Orsola-Malpighi, 40138, Bologna, Italy. Electronic address:
    The use of direct oral anticoagulants including apixaban, rivaroxaban, and dabigatran, which are approved for several therapeutic indications, can simplify perioperative and postoperative management of anticoagulation. Utilization of regional neuraxial anesthesia in patients receiving anticoagulants carries a relatively small risk of hematoma, the serious complications of which must be acknowledged. Given the extensive use of regional anesthesia in surgery and the increasing number of patients receiving direct oral anticoagulants, it is crucial to understand the current clinical data on the risk of hemorrhagic complications in this setting, particularly for anesthesiologists. Read More

    Medical complications following splenectomy.
    J Visc Surg 2016 Aug 8;153(4):277-86. Epub 2016 Jun 8.
    Université Paris Diderot-Paris 7, Hôpital Beaujon, Service de Médecine Interne, 100, boulevard du Général-Leclerc, 92110 Clichy, France. Electronic address:
    Splenectomy is attended by medical complications, principally infectious and thromboembolic; the frequency of complications varies with the conditions that led to splenectomy (hematologic splenectomy, trauma, presence of portal hypertension). Most infectious complications are caused by encapsulated bacteria (Meningococcus, Pneumococcus, Hemophilus). These occur mainly in children and somewhat less commonly in adults within the first two years following splenectomy. Read More

    Perioperative bridging anticoagulation for atrial fibrillation-the first randomised controlled trial.
    Perioper Med (Lond) 2016 7;5:14. Epub 2016 Jun 7.
    Department of Anaesthesia and Intensive Care Medicine, University Hospital of South Manchester, Wythenshawe, UK.
    Abstract: Patients who have atrial fibrillation (AF) have increased thromboembolic risk. This risk is mitigated through use of anticoagulants, traditionally with vitamin K antagonists such as warfarin, and more recently with drugs such as Xa and thrombin inhibitors. Since anticoagulants increase the risk of bleeding, uncertainty exists regarding their use in the perioperative period. Read More

    Management of floating thrombus in the aortic arch.
    J Thorac Cardiovasc Surg 2016 Sep 13;152(3):810-7. Epub 2016 Apr 13.
    Clinic of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address:
    Objective: Floating aortic thrombus is an underrecognized source of systemic emboli and carries a life-threatening risk of stroke when located in the aortic arch. Optimal treatment is not established in available guidelines. We report our experience in managing floating thrombi in the aortic arch. Read More

    Safety of transesophageal echocardiography during extracorporeal life support.
    Perfusion 2016 Apr 28. Epub 2016 Apr 28.
    Department of Anesthesiology and Critical Care Medicine, Eberhard Karls University, Tübingen, Germany
    Introduction: Use of extracorporeal life support (ECLS) has significantly increased in critically ill patients refractory to medical management. ECLS requires systemic anticoagulation to avoid thromboembolic complications and superimposed coagulopathies are common. Transesophageal echocardiography (TEE) is frequently employed to assess cannula position and cardiac function during extracorporeal therapy. Read More

    Bleeding management in patients with new oral anticoagulants.
    Minerva Anestesiol 2016 Aug 28;82(8):884-94. Epub 2016 Apr 28.
    Unit of Anesthesia and Intensive Care, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy -
    New oral anticoagulants (NOACs) have been developed in recent years and are increasingly used in clinical practice. Dabigatran is a direct thrombin (factor II) inhibitor while rivaroxaban, apixaban and edoxaban are direct inhibitors of factor Xa. The European Medicines Agency (EMA) currently approves these NOACs for different clinical uses. Read More

    A critical balance: managing coagulation in patients with glioma.
    Expert Rev Neurother 2016 Jul 9;16(7):803-14. Epub 2016 May 9.
    a Pencer Brain Tumor Centre , Princess Margaret Hospital Cancer Centre , Toronto , Canada.
    Cancer-associated thrombosis, including both arterial and venous thromboembolism (VTE), is a significant source of morbidity and mortality in patients with glioma. This risk is highest in the immediate postoperative period and is increased by chemotherapy, radiation, and corticosteroids. Systemic anticoagulation with low molecular weight heparin is the treatment of choice in both the therapeutic and prophylactic settings. Read More

    The BRIDGE trial: What the hospitalist should know.
    J Hosp Med 2016 Sep 21;11(9):652-7. Epub 2016 Apr 21.
    Department of Medicine, Anticoagulation and Clinical Thrombosis Services, Hofstra-Northwell Health School of Medicine, Northwell Health at Lenox Hill Hospital, New York, New York.
    Atrial fibrillation patients often require warfarin interruption for an invasive procedure or surgery. Heparin bridging therapy has been frequently used during warfarin interruption under the premise of providing a theoretical mitigation against thromboembolism that overweighs expected higher rates of bleeding. Up until recently, little definite clinical evidence was available to guide the hospitalist on optimal perioperative anticoagulant management. Read More

    [Anesthesiological care in orthogeriatric co-management. Perioperative treatment of geriatric trauma patients].
    Z Gerontol Geriatr 2016 Apr 18;49(3):237-55. Epub 2016 Apr 18.
    Klinik für Anästhesiologie und Allgemeine Intensivmedizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
    Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Read More

    Initial Experience of the American Society of Regional Anesthesia and Pain Medicine Coags Regional Smartphone Application: A Novel Report of Global Distribution and Clinical Usage of an Electronic Decision Support Tool to Enhance Guideline Use.
    Reg Anesth Pain Med 2016 May-Jun;41(3):334-8
    From the Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, TN.
    Background And Objectives: Decision support tools have been demonstrated to improve adherence to medical guidelines; however, smartphone applications (apps) have not been studied in this regard. In a collaboration between Vanderbilt University and the American Society of Regional Anesthesia and Pain Medicine (ASRA), the ASRA Coags Regional app was created to be a decision support tool for the 2010 published guideline on regional anesthesia for patients receiving anticoagulation. This is a review of the distribution and usage of this app. Read More

    Novel oral anticoagulants in plastic surgery.
    J Plast Reconstr Aesthet Surg 2016 May 2;69(5):585-93. Epub 2016 Mar 2.
    Blond McIndoe Laboratories, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; Department of Plastic Surgery & Burns, University Hospital of South Manchester, Manchester, UK.
    Novel oral anticoagulants (NOACs) have emerged as a good alternative to warfarin in the prevention of stroke for patients with atrial fibrillation. NOAC use is increasing rapidly; therefore, greater understanding of their use in the perioperative period is important for optimal care. Studies and reviews that reported on the use of NOACs were identified, with particular focus on the perioperative period. Read More

    Heparin-induced thrombocytopenia in solid organ transplant recipients: The current scientific knowledge.
    World J Transplant 2016 Mar;6(1):165-73
    Volker Assfalg, Norbert Hüser, Department of Surgery, Klinikum rechts der Isar der Technischen Universität München, D-81675 Munich, Germany.
    Exposure to heparin is associated with a high incidence of immunization against platelet factor 4 (PF4)/heparin complexes. A subgroup of immunized patients is at risk of developing heparin-induced thrombocytopenia (HIT), an immune mediated prothrombotic adverse drug effect. Transplant recipients are frequently exposed to heparin either due to the underlying end-stage disease, which leads to listing and transplantation or during the transplant procedure and the perioperative period. Read More

    Periprocedural management of patients receiving a vitamin K antagonist or a direct oral anticoagulant requiring an elective procedure or surgery.
    J Thromb Haemost 2016 May 7;14(5):875-85. Epub 2016 Apr 7.
    Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
    The periprocedural management of patients receiving chronic therapy with oral anticoagulants (OACs), including vitamin K antagonists (VKAs) such as warfarin and direct OACs (DOACs), is a common clinical problem. The optimal perioperative management of patients receiving chronic OAC therapy is anchored on four key principles: (i) risk stratification of patient-related and procedure-related risks of thrombosis and bleeding; (ii) the clinical consequences of a thrombotic or bleeding event; (iii) discontinuation and reinitiation of OAC therapy on the basis of the pharmacokinetic properties of each agent; and (iv) whether aggressive management such as the use of periprocedural heparin bridging has advantages for the prevention of postoperative thromboembolism at the cost of a possible increase in bleeding risk. Recent data from randomized trials in patients receiving VKAs undergoing pacemaker/defibrillator implantation or using heparin bridging therapy for elective procedures or surgeries can now inform best practice. Read More

    The Periprocedural Management of Anticoagulation and Platelet Aggregation Inhibitors in Endoscopic Interventions.
    Dtsch Arztebl Int 2016 Feb;113(8):129-35
    Gastroenterology and Hepatology, Department of Medicine 1, Frankfurt University Hospital, Frankfurt am Main, Cardiology, Department of Medicine 3, Frankfurt University Hospital, Frankfurt am Main, Hemostaseology, Department of Medicine 2, Frankfurt University Hospital, Frankfurt am Main.
    Background: In Germany, more than half a million persons, most of them elderly, are under long-term treatment with anticoagulants. The approval of new oral anticoagulants and platelet aggregation inhibitors, as well as new data on periprocedural bridging with heparins, have introduced marked complexity to the management of treatment with anticoagulants and platelet aggregation inhibitors for endoscopic interventions in visceral surgery.

    Methods: This review is based on pertinent publications retrieved by a selective literature search in PubMed, as well as on the relevant guidelines. Read More

    Noncardiac Challenges in the Cardiac ICU: Feeding, Growth and Gastrointestinal Complications, Anticoagulation, and Analgesia.
    World J Pediatr Congenit Heart Surg 2016 Mar;7(2):199-209
    The Heart Institute, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
    Outcomes following cardiac intensive care unit (CICU) admission are influenced by many factors including initial cardiac diagnosis, surgical complexity, and burden of critical illness. Additionally, the presence of noncardiac issues may have a significant impact on outcomes and the patient experience during and following an intensive care unit stay. This review focuses on three common noncardiac areas which impact outcomes and patient experience in and beyond the CICU: feeding and growth, pain and analgesia, and anticoagulation. Read More

    Vascular complications in glioma patients.
    Handb Clin Neurol 2016 ;134:251-66
    Division of Neurology, Odette Cancer Centre and Sunnybrook Health Science Centre, University of Toronto, Toronto, Canada. Electronic address:
    Vascular complications in patients with glioma most commonly include venous and arterial thromboembolism; however, treatment-induced vasculopathies are also problematic, especially in long-term survivors. The interactions between treatment such as radiation and chemotherapy, the coagulation cascade, endothelium, and regulators of angiogenesis are complex, drive glioma growth and invasion, and create common management problems in the clinic. We review the incidence of thrombotic complications in glioma, the biology of the coagulome as related to glioma progression, prevention and treatment of thrombosis, the role of anticoagulants as anticancer therapy, and vascular complications such as ischemic stroke and intracranial bleeding. Read More

    1 OF 12