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Wiegele, M; Schöchl, H; Haushofer, A; Ortler, M; Leitgeb, J; Kwasny, O; Beer, R; Ay, C; Schaden, E.
Diagnostic and therapeutic approach in adult patients with traumatic brain injury receiving oral anticoagulant therapy: an Austrian interdisciplinary consensus statement.
Crit Care. 2019; 23(1): 62-62. Doi: 10.1186/s13054-019-2352-6 [OPEN ACCESS]
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Co-authors Med Uni Graz
Haushofer Alexander
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Abstract:
There is a high degree of uncertainty regarding optimum care of patients with potential or known intake of oral anticoagulants and traumatic brain injury (TBI). Anticoagulation therapy aggravates the risk of intracerebral hemorrhage but, on the other hand, patients take anticoagulants because of an underlying prothrombotic risk, and this could be increased following trauma. Treatment decisions must be taken with due consideration of both these risks. An interdisciplinary group of Austrian experts was convened to develop recommendations for best clinical practice. The aim was to provide pragmatic, clear, and easy-to-follow clinical guidance for coagulation management in adult patients with TBI and potential or known intake of platelet inhibitors, vitamin K antagonists, or non-vitamin K antagonist oral anticoagulants. Diagnosis, coagulation testing, and reversal of anticoagulation were considered as key steps upon presentation. Post-trauma management (prophylaxis for thromboembolism and resumption of long-term anticoagulation therapy) was also explored. The lack of robust evidence on which to base treatment recommendations highlights the need for randomized controlled trials in this setting.
Find related publications in this database (using NLM MeSH Indexing)
Administration, Oral -
Anticoagulants - adverse effects
Anticoagulants - therapeutic use
Anticoagulants -
Brain Injuries, Traumatic - drug therapy
Brain Injuries, Traumatic - physiopathology
Consensus -
Dabigatran - adverse effects
Dabigatran - therapeutic use
Deamino Arginine Vasopressin - pharmacology
Humans -
Interdisciplinary Communication -
Partial Thromboplastin Time - methods
Pyrazoles - analysis
Pyrazoles - blood
Pyrazoles - therapeutic use
Pyridines - analysis
Pyridines - blood
Pyridines - therapeutic use
Pyridones - analysis
Pyridones - blood
Pyridones - therapeutic use
Rivaroxaban - analysis
Rivaroxaban - blood
Rivaroxaban - therapeutic use
Thiazoles - analysis
Thiazoles - blood
Thiazoles - therapeutic use
Thromboembolism - prevention & control
Tomography, X-Ray Computed - methods
Tranexamic Acid - therapeutic use
Treatment Outcome -
Vitamin K - antagonists & inhibitors
Vitamin K - therapeutic use

Find related publications in this database (Keywords)
Anticoagulation reversal
Coagulation management
Idarucizumab
Intracranial hemorrhage
Non-vitamin K antagonist oral anticoagulant (NOAC)
Platelet inhibitors
Prothrombin complex concentrate (PCC)
Traumatic brain injury
Vitamin K antagonist (VKA)
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