Polzin A, Kelm M, Horn P
Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum der Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Med Klin Intensivmed Notfmed. 2017 Mar;112(2):117-124. doi: 10.1007/s00063-016-0239-8. Epub 2017 Jan 10.
Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used in patients with deep vein thrombosis (DVT), pulmonary embolism (PE) and atrial fibrillation (AF). However, there is insufficient data concerning the periinterventional, perioperative, and intensive care management of patients on NOACs. Therefore, the recommendations regarding this management rely on pharmacokinetics of the particular NOAC in combination with the individual patient's characteristics, bleeding risk of the planned intervention/surgery, and urgency of the procedure. This review summarizes evidence and recommendations regarding the optimal periinterventional/perioperative antithrombotic management of patients on NOACs.
非维生素K拮抗剂口服抗凝药(NOACs)越来越多地用于治疗深静脉血栓形成(DVT)、肺栓塞(PE)和心房颤动(AF)患者。然而,关于服用NOACs患者的围介入期、围手术期及重症监护管理的数据不足。因此,关于这一管理的建议依赖于特定NOAC的药代动力学,结合个体患者的特征、计划的介入治疗/手术的出血风险以及手术的紧迫性。本综述总结了关于服用NOACs患者最佳围介入期/围手术期抗栓管理的证据和建议。