Donna Barakeh, Kevin R Donahue, Mahmoud Sabawi, Diane Dreucean
{"title":"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。","authors":"Donna Barakeh, Kevin R Donahue, Mahmoud Sabawi, Diane Dreucean","doi":"10.1093/ajhp/zxaf059","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Summary: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":7577,"journal":{"name":"American Journal of Health-System Pharmacy","volume":" ","pages":"1022-1025"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of thrombin time to transition from dabigatran to intravenous unfractionated heparin in patients with acute kidney injury.\",\"authors\":\"Donna Barakeh, Kevin R Donahue, Mahmoud Sabawi, Diane Dreucean\",\"doi\":\"10.1093/ajhp/zxaf059\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Summary: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":7577,\"journal\":{\"name\":\"American Journal of Health-System Pharmacy\",\"volume\":\" \",\"pages\":\"1022-1025\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Health-System Pharmacy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ajhp/zxaf059\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Health-System Pharmacy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ajhp/zxaf059","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
Use of thrombin time to transition from dabigatran to intravenous unfractionated heparin in patients with acute kidney injury.
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.
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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