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Perioperative anticoagulation guidelines

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https://www.readbyqxmd.com/read/29770858/-management-of-anticoagulants-in-ophthalmic-surgery-a-survey-among-ophthalmic-surgeons-in-germany
#1
N Feltgen, B Mele, T Dietlein, C Erb, A Eckstein, A Hager, A Heiligenhaus, H Helbig, H Hoerauf, E Hoffmann, D Pauleikhoff, M Schittkowski, B Seitz, C Sucker, S Suffo, U Schaudig, F Tost, S Thurau, P Walter, J Koscielny
INTRODUCTION: As our population ages and comorbidities rise, ophthalmic surgeons are increasingly faced with patients on anticoagulant therapy or with clotting disorders. The ophthalmic surgeon has to weigh the perioperative risk of haemorrhage when anticoagulation continues against the risk of thromboembolism caused by discontinuation or changing the patient's medication (bridging, switching, cessation). There are currently no guidelines or recommendations. METHODS: A survey was sent to the DOG (German Ophthalmologic Society) divisions and associated surgical organizations to determine the status quo...
May 16, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/29710221/what-surgeons-should-know-about-non-vitamin-k-oral-anticoagulants-a-review
#2
Atul Verma, Andrew C T Ha, James T Rutka, Subodh Verma
Importance: Non-vitamin K oral anticoagulants (NOACs) are increasingly prescribed for patients to treat or prevent arterial or venous thromboembolism. The following 4 NOAC agents are approved by the US Food and Drug Administration for clinical use: dabigatran etexilate, apixaban, edoxaban tosylate, and rivaroxaban. A good understanding of these agents' pharmacologic properties is important for surgeons given their marked differences compared with warfarin sodium. This review highlights key practical issues surrounding the use of NOACs in the perioperative setting...
April 18, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29700892/prevention-of-perioperative-venous-thromboembolism-in-pediatric-patients-guidelines-from-the-association-of-paediatric-anaesthetists-of-great-britain-and-ireland-apagbi
#3
Judith Morgan, Matthew Checketts, Amaia Arana, Elizabeth Chalmers, Jamie Maclean, Mark Powis, Neil Morton
The Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) Guidelines Working Group on Thromboprophylaxis in Children has reviewed the literature and where possible provided advice on the care of children in the perioperative period. Areas reviewed include the incidence of perioperative venous thromboembolism (VTE), risk factors, evidence for mechanical and chemical prophylaxis, and complications. Safe practice of regional anesthesia with anticoagulant prophylaxis is detailed. In summary, there are few areas of strong evidence...
April 27, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29678618/concomitant-surgical-atrial-fibrillation-ablation-is-safe-and-efficacious-in-patients-undergoing-double-valve-replacement-a-cohort-study
#4
Guang Tong, Hao Yu, Xuan Zhou, Ben Zhang, Shenghui Bi, Lin Luo, Tao Yan, Xianyue Wang, Hua Lu, Tao Ma, Xiaowu Wang, Zhongchan Sun, Weida Zhang
BACKGROUND: Current European Society of Cardiology Guidelines recommend concomitant atrial fibrillation (AF) ablation for all symptomatic patients undergoing other cardiac surgeries, but the safety and potential benefits of concomitant atrial fibrillation (AF) ablation at the time of double valve replacement (DVR: aortic and mitral valve replacement) remains unexamined. MATERIALS AND METHODS: We conducted a retrospective review of 238 patients with AF who underwent DVR with or without concomitant surgical ablation (Ablation group, n=113; Non-ablation group, n=125) at a single institute from April 2006 to September 2011...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29663585/perioperative-anticoagulation-practices-for-pediatric-liver-transplantation
#5
Stylianos Voulgarelis, Bernadette Vitola, Stacee M Lerret, Johnny C Hong, John P Scott
Despite continued advancements in perioperative care for pediatric liver transplant (LT), graft-threatening vascular occlusion events including hepatic artery thrombosis (HAT) and portal vein thrombosis (PVT) remain a source of significant morbidity and mortality. Perioperative anticoagulation is commonly used for the prevention of HAT and PVT, but evidence-based guidelines are lacking. The goals of this survey were to determine the frequency of use of an anticoagulation protocol and to describe variation in anticoagulation practices among pediatric LT centers...
April 16, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29619276/use-of-anticoagulants-remains-a-significant-threat-to-timely-hip-fracture-surgery
#6
Razvan Taranu, Chelsea Redclift, Patrick Williams, Marina Diament, Anne Tate, Jamie Maddox, Faye Wilson, Will Eardley
Introduction: Hip fracture remains the biggest single source of morbidity and mortality in the elderly trauma population, and any intervention focused on quality improvement and system efficiency is beneficial for both patients and clinicians. Two of the variables contributory to improving care and efficiency are time to theater and length of stay, with the overall goal being to improve care as reflected within the achievement of best practice tariff. One of the biggest barriers to optimizing these variables is preinjury anticoagulation...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29611483/management-of-antithrombotic-therapy-in-patients-with-coronary-artery-disease-or-atrial-fibrillation-who-underwent-abdominal-surgical-operations
#7
Dimitrios Schizas, Maria Kariori, Konstantinos Dean Boudoulas, Gerasimos Siasos, Nikolaos Patelis, Charalampos Kalantzis, Moldovan Carmen-Maria, Manolis Vavuranakis
BACKGROUND: Patients treated with antithrombotic therapy that require abdominal surgical procedures has progressively increased overtime. The management of antithrombotics during both the peri- and post- operative period is of crucial importance. METHODS: The goal of this review is to present current data concerning the management of antiplatelets in patients with coronary artery disease and of anticoagulants in patients with atrial fibrillation who had to undergo abdominal surgical operations...
April 2, 2018: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29537161/management-of-antithrombotic-agents-in-dermatologic-surgery-before-and-after-publication-of-the-corresponding-german-evidence-based-guideline
#8
Matthew Gaskins, Martin Dittmann, Lisa Eisert, Ricardo Niklas Werner, Corinna Dressler, Christoph Löser, Alexander Nast
BACKGROUND: A survey in 2012 revealed marked heterogeneity in the management of antithrombotic agents in dermatologic surgery in Germany. An evidence-based guideline on this topic was published for the first time in 2014. METHODS: Using the same study sample, we conducted an anonymous survey on the management of antithrombotic agents and familiarity with the guideline. We reported the results as relative frequencies and compared them with those from 2012. RESULTS: We analyzed a total of 208 questionnaires (response rate: 36...
March 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29523996/new-onset-atrial-fibrillation-an-update
#9
REVIEW
Takeshi Omae, Eiichi Inada
New-onset atrial fibrillation (NOAF) is the most common perioperative complication of heart surgery, typically occurring in the perioperative period. NOAF commonly occurs in patients who are elderly, or have left atrial enlargement, or left ventricular hypertrophy. Various factors have been identified as being involved in the development of NOAF, and numerous approaches have been proposed for its prevention and treatment. Risk factors include diabetes, obesity, and metabolic syndrome. For prevention of NOAF, β-blockers and amiodarone are particularly effective and are recommended by guidelines...
March 9, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29523011/perioperative-use-of-anticoagulant-and-platelet-inhibiting-medications-for-elective-spine-surgery-results-of-a-nationwide-survey
#10
Dominik Baschera, Joachim Oberle, Florian Grubhofer, Samuel Luca Schmid
BACKGROUND AND STUDY AIMS:  Perioperative use of anticoagulant and platelet-inhibiting agents by patients undergoing spine surgery poses the dilemma of increased risk of hemorrhage. We examined the standards of use for these medications and expert opinions through a nationwide survey. MATERIALS AND METHODS:  An online-based survey was conducted by invitation. A personal token to access the survey was sent to one representative of each neurosurgical and orthopaedic unit performing spine surgery and to all other active members of the Swiss Society of Neurosurgery and the Swiss Society of Spinal Surgery...
March 9, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29521074/thromboprophylaxis-in-cancer-patients-in-hospice
#11
REVIEW
Ewa Zabrocka, Marek Z Wojtukiewicz, Ewa Sierko
Advanced cancer patients in hospice are at notably increased risk of venous thromboembolism (VTE) due to age, local and distal advancement of the malignancy and bed confinement, among other factors. Asymptomatic VTE prevalence among palliative care patients has been found to reach 50%, whereas the clinically overt form occurs in 10%. Hospice patients are frequently given medications increasing VTE risk, for instance megestrol which is a drug commonly used in cancer cachexia. Many of the available guidelines encourage the implementation of thromboprophylaxis (TPX) in cancer patients, e...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/29518801/new-atrial-fibrillation-diagnosed-perioperatively-anticoagulation-practices-in-a-secondary-hospital
#12
Alyssa Kirby, Sisira Jayathissa
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia encountered perioperatively in patients undergoing non-cardiac surgery. There is emerging evidence suggesting high risk of ischaemic stroke. There are no clear guidelines surrounding initiation of anticoagulation in this setting. This study evaluates current practice in anticoagulant management of new perioperative AF at Hutt Hospital. METHODS: We have undertaken a retrospective study of 3,558 patients aged 60 years and over admitted for non-cardiac surgery at Hutt Hospital in 2014, to assess incidence of new AF/flutter and review how they were managed in regards to anticoagulation...
March 9, 2018: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29477682/perioperative-outcomes-are-adversely-affected-by-poor-pretransfer-adherence-to-acute-limb-ischemia-practice-guidelines
#13
S Keisin Wang, Michael P Murphy, Ashley R Gutwein, Natalie A Drucker, Michael C Dalsing, Raghu L Motaganahalli, Gary W Lemmon, A George Akingba
BACKGROUND: The accepted treatment for acute limb ischemia (ALI) is immediate systemic anticoagulation and timely reperfusion to restore blood flow. In this study, we describe the retrospective assessment of pretransfer management decisions by referring hospitals to an academic tertiary care facility and its impact on perioperative adverse events. METHODS: A retrospective analysis of ALI patients transferred to us via our Level I Vascular Emergency Program from 2010 to 2013 was performed...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29325349/-introduction-and-interpretation-of-guidelines-on-thromboprophylaxis-in-the-perioperative-period-of-urological-surgery
#14
X Wang, Z Y Liu
Venous thromboembolism had drawn great attention of global experts, as it is the third leading cause of cardiovascular-associated death, ranking after coronary heart disease and stroke. Numerous health care organizations had introduced guidelines for thromboprophylaxis during the perioperative period in their own fields. The paper reviewed the available guidelines pertaining to urological surgery from America Urological Association, American College of Chest Physicians and European Association of Urology. Compared with the first two guidelines, the European Association of Urology guideline is a milestone which recommended the most detailed prophylactic measures for the procedure-specific and patient-specific according to the evidence-based medicine...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29283294/evaluating-the-role-of-clinical-pharmacists-in-pre-procedural-anticoagulation-management
#15
Akash Kataruka, Elizabeth Renner, Geoffrey D Barnes
OBJECTIVES: While physicians are typically responsible for managing perioperative warfarin, clinic pharmacists may improve pre-procedural decision-making. We assessed the impact of pharmacist-driven care for chronic warfarin-treated patients undergoing outpatient right heart catheterization (RHC). METHODS: 200 warfarin patients who underwent RHC between January 2012 and September 2015 were analyzed. Pharmacist-care (n = 79) was compared to the usual care model (n = 121)...
February 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29246544/long-term-outcome-following-concomitant-mitral-valve-surgery-and-cox-maze-procedure-for-atrial-fibrillation
#16
Niv Ad, Sari D Holmes, Paul S Massimiano, Anthony J Rongione, Lisa M Fornaresio
OBJECTIVE: Atrial fibrillation (AF) is associated with increased early and long-term morbidity/mortality following valve surgery. This study examined long-term influence of concomitant full Cox maze (CM) and mitral valve procedures on freedom from atrial arrhythmia and stroke. METHODS: This sample comprised patients who underwent CM with a mitral valve procedure (N = 473). Data on rhythm, medication status, and clinical events captured according to Heart Rhythm Society guidelines at 6, 9, 12, 18, and 24 months and yearly thereafter up to 7 years...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29241314/perioperative-antithrombotic-therapy-in-patients-undergoing-endoscopic-urologic-surgery-where-do-we-stand-with-current-literature
#17
Richard Naspro, Lori B Lerner, Roberta Rossini, Michele Manica, Henry H Woo, Ross J Calopedos, Cecilia M Cracco, Cesare M Scoffone, Thomas R Herrmann, Jean J de la Rosette, Jean-Nicolas Cornu, Luigi F DA Pozzo
INTRODUCTION: The number of patients on chronic anticoagulant or antiplatelet therapy requiring endoscopic urological surgery is increasing worldwide. Therefore, there is a strong demand to standardize the peri-operative treatment of this cohort of patients, both from a surgical and cardiological point of view, balancing the risks of bleeding versus thrombosis, and the important possible clinical and medical legal repercussions therein. EVIDENCE ACQUISITION: Although literature is scarce and the quality of evidence quite low, in line with other surgical specialties, guidelines and recommendations for the management of urological patients have begun to emerge...
December 14, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/29186582/safety-of-spinal-cord-stimulation-in-patients-who-routinely-use-anticoagulants
#18
Hirah Khan, Vignessh Kumar, Zohal Ghulam-Jelani, Sarah E McCallum, Ellie Hobson, Vishad Sukul, Julie G Pilitsis
Objective: We assess the safety of performing the epidural placement or revision of spinal cord stimulation (SCS) in patients whose anticoagulation has been held (termed "anticoagulant-suspended" patients) in accordance with the 2017 Neurostimulation Appropriateness Consensus Committee (NACC) guidelines. Subjects: Patients undergoing SCS were included in this institutional review board-approved study. Design: A retrospective analysis of a prospectively collected database was performed...
November 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29138143/minimally-invasive-stand-alone-cox-maze-procedure-for-persistent-and-long-standing-persistent-atrial-fibrillation-perioperative-safety-and-5-year-outcomes
#19
Niv Ad, Sari D Holmes, Ted Friehling
BACKGROUND: Rhythm control is challenging in patients with extended atrial fibrillation (AF) duration and persistent/long-standing persistent AF. Among surgical approaches to treat AF, the Cox maze procedure performed using alternative energy sources remains superior to other beating heart techniques. We examined permanence of safety and success for the on-pump, minimally invasive, stand-alone Cox maze procedure 5 years after surgery. METHODS AND RESULTS: Stand-alone, right 5 cm minithoracotomy, Cox maze III/IV procedure for nonparoxysmal AF was conducted in 133 patients (mean follow-up=65±34 months)...
November 2017: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29136561/calibrated-automated-thrombogram-values-in-infants-with-cardiac-surgery-before-and-after-cardiopulmonary-bypass
#20
Alessandra Rizza, Giovina Di Felice, Rosa Luciano, Ottavia Porzio, Ombretta Panizzon, Maurizio Muraca, Paola Cogo
INTRODUCTION: Impaired thrombin generation has been associated to increase bleeding after cardiac surgery with cardiopulmonary bypass (CPB), especially in children. The aim of this study was to evaluate standard coagulation assay, thrombin generation by calibrated automated thrombogram (CAT), thromboelastography (TEG) and procoagulant phospholipids (PPL) activity in infants undergoing cardiac surgery with CPB. MATERIALS AND METHODS: Prospective observational study performed in children aged <24months undergoing cardiac surgery with CPB...
December 2017: Thrombosis Research
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