Eingriffe unter NOAK

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Zusammenfassung

Nicht-Vitamin-K-antagonistische orale Antikoagulanzien (NOAK) werden in den letzten Jahren vermehrt bei Patienten mit nichtvalvulärem Vorhofflimmern, venöser Thrombose und Lungenembolie eingesetzt. Allerdings sind die Erfahrungen mit diesen neuen Substanzen im Rahmen des periinterventionellen, perioperativen und intensivmedizinischen Managements noch sehr eingeschränkt. Aufgrund der fehlenden Evidenz basieren die aktuellen Empfehlungen zum Umgang mit Patienten unter NOAK in diesem Rahmen auf Analysen der Pharmakokinetik in Kombination mit patientenspezifischen Charakteristiken, dem jeweiligen Blutungsrisiko des geplanten Eingriffs und der Dringlichkeit der Prozedur. Dieser Review fasst die Evidenz und Empfehlungen zum optimalen periinterventionellen/perioperativen/intensivmedizinischen antithrombotischen Management bei Patienten unter NOAK-Therapie zusammen.

Schlüsselwörter

Blutung Antikoagulanzien Perioperatives Management Intensivmedizin Pharmakokinetik 

Procedures on patients receiving NOACs

What’s possible?

Abstract

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.

Keywords

Bleeding Anticoagulants Perioperative care Intensive care Pharmacokinetics 

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Copyright information

© Springer Medizin Verlag Berlin 2016

Authors and Affiliations

  1. 1.Klinik für Kardiologie, Pneumologie und AngiologieUniversitätsklinikum der Heinrich-Heine-Universität DüsseldorfDüsseldorfDeutschland

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