Title :

Management of antiplatelet therapy for non elective invasive procedures of bleeding complications: proposals from the French working group on perioperative haemostasis (GIHP), in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR)

Author(s) :

Godier, A [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Innovations thérapeutiques en hémostase = Innovative Therapies in Haemostasis [IThEM - U1140]
Garrigue, D [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Lasne, D [Auteur]
Hôpital Necker - Enfants Malades [AP-HP]
Fontana, P [Auteur]
Université de Genève = University of Geneva [UNIGE]
Hôpitaux Universitaires de Genève [HUG]
Bonhomme, F [Auteur]
Hôpitaux Universitaires de Genève [HUG]
Collet, J. P. [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Institut de cardiologie [CHU Pitié-Salpêtrière]
Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [ICAN]
de Maistre, E [Auteur]
Plateau technique de Biologie [CHU de Dijon]
Ickx, B [Auteur]
Hôpital Erasme = Erasmus Hospital = Erasmus Ziekenhuis [HUB-ULB]
Gruel, Y [Auteur]
Service d'hématologie [Tours]
Mazighi, M [Auteur]
CIC - CHU Bichat
Laboratoire de Recherche Vasculaire Translationnelle [LVTS (UMR_S_1148 / U1148)]
Nguyen, P [Auteur]
Hôpital universitaire Robert Debré [Reims] [CHU Reims]
Vincentelli, A [Auteur]
Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 [RNMCD]
Albaladejo, P [Auteur]
Techniques pour l'Evaluation et la Modélisation des Actions de la Santé [TIMC-IMAG-ThEMAS]
Lecompte, T [Auteur]
Université de Genève = University of Geneva [UNIGE]
Hôpitaux Universitaires de Genève [HUG]

Journal title :

Anaesthesia Critical Care & Pain Medicine

Pages :

289-302

Publisher :

Elsevier Masson

Publication date :

2019-06

ISSN :

2352-5568

English keyword(s) :

antiplatelet agents
bleeding
invasive procedures
platelet transfusion
rFVIIa
surgery
thrombosis
tranexamic acid

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR) drafted ...
Show more >The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society of Anaesthesia and Intensive Care Medicine (SFAR) drafted up-to-date proposals on the management of antiplatelet therapy for non-elective invasive procedures or bleeding complications. The proposals were discussed and validated by a vote; all proposals could be assigned with a high strength. Emergency management of oral antiplatelet agents (APA) requires knowledge on their pharmacokinetic/pharmacodynamics parameters, evaluation of the degree of the alteration of haemostatic competence and the associated bleeding risk. Platelet function testing may be considered. When APA-induced bleeding risk may worsen the prognosis, measures should be taken to neutralise antiplatelet therapy by considering not only the efficacy of available means (which can be limited for prasugrel and even more for ticagrelor) but also the risks that these means expose the patient to. The measures include platelet transfusion at the appropriate dose and haemostatic agents (tranexamic acid; rFVIIa for ticagrelor). When possible, postponing non-elective invasive procedures at least for a few hours until the elimination of the active compound (which could compromise the effect of transfused platelets) or if possible a few days (reduction of the effect of APA) should be considered.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Collections :

• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011

Source :

Harvested from HAL