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[急性肾损伤患者出现达比加群过量:手术时进行血液透析]

[Patient with acute renal injury presenting dabigatran overdose: Hemodialysis for surgery].

作者信息

Bachellerie B, Ruiz S, Conil J-M, Crognier L, Seguin T, Georges B, Fourcade O

机构信息

Pôle d'anesthésie réanimation, hôpital de Rangueil, 31059 Toulouse cedex 9, France.

Pôle d'anesthésie réanimation, hôpital de Rangueil, 31059 Toulouse cedex 9, France.

出版信息

Ann Fr Anesth Reanim. 2014 Jan;33(1):44-6. doi: 10.1016/j.annfar.2013.11.011. Epub 2013 Dec 28.

Abstract

Dabigatran is a direct thrombin inhibitor indicated for stroke and systemic embolism prevention in patients with non-valvular atrial fibrillation. No reversal agent exists, but hemodialysis has been proposed as dabigatran removal method. We report a case of an 80-year-old man presenting hemorrhage with dabigatran overdose caused by obstructive acute renal failure. Before nephrostomy, several hemodialysis sessions were necessary to remove dabigatran probably because of its large volume of distribution.

摘要

达比加群是一种直接凝血酶抑制剂,适用于非瓣膜性心房颤动患者预防中风和全身性栓塞。目前尚无逆转剂,但血液透析已被提议作为去除达比加群的方法。我们报告一例80岁男性因梗阻性急性肾衰竭导致达比加群过量而出现出血的病例。在进行肾造瘘术前,可能由于达比加群分布容积较大,需要进行多次血液透析以清除达比加群。

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