Use of thrombin time to transition from dabigatran to intravenous unfractionated heparin in patients with acute kidney injury.

IF 2.3 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Donna Barakeh, Kevin R Donahue, Mahmoud Sabawi, Diane Dreucean
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引用次数: 0

Abstract

Purpose: This case series explores the use of thrombin time (TT) to transition 2 patients from dabigatran to unfractionated heparin (UFH) in the setting of acute kidney injury (AKI) and coagulopathy concerning for dabigatran accumulation.

Summary: Serial TT monitoring was employed until the value began to trend below 120 seconds, indicating ongoing drug clearance, at which point UFH was initiated. Patient 1 experienced rectal bleeding following initiation of UFH, while patient 2 experienced hemoglobin drops without an apparent bleeding source. No thrombotic events occurred during either hospitalization.

Conclusion: Individualized management remains paramount to balance bleeding and thrombotic risk based on patient-specific factors. Further research is warranted to validate the safety and efficacy of a TT-guided transition strategy and optimize protocols for hospitalized patients transitioning from dabigatran to UFH.

急性肾损伤患者使用凝血酶时间从达比加群过渡到静脉注射普通肝素。
免责声明:为了加快文章的发表,AJHP在接受稿件后将尽快在网上发布。被接受的稿件已经过同行评审和编辑,但在技术格式化和作者校对之前会在网上发布。这些手稿不是记录的最终版本,稍后将被最终文章(按照AJHP风格格式化并由作者校对)所取代。目的:本病例系列探讨在急性肾损伤(AKI)和与达比加群积累有关的凝血功能障碍的情况下,使用凝血酶时间(TT)将2例患者从达比加群过渡到未分级肝素(UFH)。摘要:连续TT监测,直到该值开始低于120秒,表明正在进行的药物清除,此时开始UFH。患者1在开始UFH后出现直肠出血,而患者2出现血红蛋白下降,但无明显出血来源。两组住院期间均未发生血栓形成事件。结论:个体化管理仍然是最重要的平衡出血和血栓形成的风险基于患者的具体因素。需要进一步的研究来验证tt引导的过渡策略的安全性和有效性,并优化住院患者从达比加群过渡到UFH的方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
18.50%
发文量
341
审稿时长
3-8 weeks
期刊介绍: The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.
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