Weinberger Jason, Cipolle Mark
Department of Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 South Greene Street, T1R53, Baltimore, MD 21201, USA.
Department of Surgery, Christiana Care Health System, Sidney Kimmel School of Medicine, Thomas Jefferson University, 4755 Ogletown-Stanton Road, Suite 1320, Wilmington, DE 19718, USA.
Crit Care Clin. 2017 Jan;33(1):135-152. doi: 10.1016/j.ccc.2016.08.005.
The incidence of patients with trauma on novel oral anticoagulants (NOACs) for the treatment of thromboembolic disorders is increasing. In severe bleeding or hemorrhage into critical spaces, urgent reversal of this underlying pharmacologic coagulopathy becomes paramount. Optimal reversal strategy for commonly used NOACs is still evolving. Basic tenets of evaluation of patients with trauma and resuscitation remain the same. Clinical outcomes data in bleeding human patients with trauma are lacking, but are needed to establish efficacy and safety in these treatments. This article summarizes the available evidence and provides the optimal reversal strategy for bleeding patients with trauma on NOACs.
使用新型口服抗凝剂（NOACs）治疗血栓栓塞性疾病的创伤患者的发病率正在上升。在严重出血或关键部位出血时，紧急逆转这种潜在的药物性凝血病变得至关重要。常用NOACs的最佳逆转策略仍在不断发展。创伤患者评估和复苏的基本原则保持不变。缺乏创伤出血患者的临床结局数据，但这些数据对于确定这些治疗方法的有效性和安全性是必要的。本文总结了现有证据，并为使用NOACs的创伤出血患者提供了最佳逆转策略。
