Carrizo Aldo, Campbell Sebastián
Servicio de Arritmias y Electrofisiología, Clínica Bazterrica, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2014;74(2):121-3.
Dabigatran is an oral anticoagulant from the class of the direct thrombin inhibitors, indicated for prevention of thromboembolic events in patients with non valvular atrial fibrillation. Unlike warfarin, dabigatran has no known antidote. Hemodialysis has been suggested as a method for removing dabigatran and thereby reducing its anticoagulant effect. We report the case of a patient with a known history of atrial fibrillation, treated with dabigatran, who was admitted for emergency abdominal surgery. At six hours after the last dose received, coagulation studies were altered. In absence of an antidote to reverse its effects, it was decided to perform hemodialysis. After three hours of dialysis coagulation parameters were improved and the patient underwent surgery without showing abnormal bleeding during surgery or in the postoperative period.
达比加群是一种直接凝血酶抑制剂类的口服抗凝剂，用于预防非瓣膜性心房颤动患者的血栓栓塞事件。与华法林不同，达比加群没有已知的解毒剂。血液透析已被建议作为一种清除达比加群从而降低其抗凝作用的方法。我们报告了一例有房颤病史且接受达比加群治疗的患者，该患者因急诊腹部手术入院。在最后一剂用药后六小时，凝血研究结果出现变化。由于没有解毒剂来逆转其作用，决定进行血液透析。透析三小时后凝血参数得到改善，患者接受了手术，术中及术后均未出现异常出血。
