The Fellow on Call: The Heme/Onc Podcast
Episode 133: VTE Series - Perioperative Anticoagulation Management and Emergent Reversal
Apr 9, 2025
Delve into the crucial considerations of managing anticoagulation during surgeries and emergencies. Learn the importance of holding and reversing anticoagulants in various clinical scenarios. The discussion emphasizes effective communication with patients and healthcare providers to ensure safety. Discover insights on using Indexanet alpha as a reversal agent and the complexities involved in individual patient care. This informative session balances technical expertise with relatable anecdotes, making it a must-listen for medical professionals.
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Quick takeaways
- Effective perioperative anticoagulation management requires careful consideration of when and how long to hold anticoagulants based on individual patient risk factors.
- Reversing anticoagulation in emergencies entails a thorough understanding of specific reversal agents and the potential risks associated with each to ensure patient safety.
Deep dives
Perioperative Anticoagulation Management Overview
Managing anticoagulation during perioperative care is crucial for patients undergoing procedures while on blood thinners. A key consideration is determining when to hold anticoagulants prior to surgery, which varies based on the type of medication and the bleeding risk of the procedure. For example, warfarin typically requires a five-day hold to allow INR levels to normalize, while studies suggest DOAC medications, like apixaban, can often be safely held for just one to two days. The collaboration between the healthcare team performing the procedure and the prescribing physician is essential to ensure the patient's safety and effective management of anticoagulation.
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