What anticoagulants should be used in the critically ill patient? How do I choose?

Document Type

Journal Article

Publication Date

1-1-2019

Journal

Evidence-Based Practice of Critical Care

DOI

10.1016/B978-0-323-64068-8.00092-4

Keywords

Anticoagulation; Direct oral anticoagulant; Reversal

Abstract

Use of anticoagulants as a means to prevent both venous and arterial thromboembolism and also as a means to treat such events when they do occur is ubiquitous in the intensive care unit (ICU). It is therefore vital that the intensivist be familiar with the various anticoagulants, their mechanisms and duration of action, their pharmacokinetic profile in patients with organ dysfunction, and the availability (or lack thereof) of specific reversal agents. Use of direct oral anticoagulants (DOACs), in particular, is becoming increasingly common, and it is vital that intensivists have a keen understanding of how these medications work and their reversal strategies in order to treat patients who present with bleeding and/or require urgent intervention.

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