Although major haemorrhage is infrequent, management can be difficult especially with antithrombotics for which there are no specific reversal agents.

Guidance on reversal of vitamin K antagonists (VKAs warfarin, phenprocoumon, acenocoumarol (sinthrome) and phenindione has been described previously (Keeling et al, 2011).Īntithrombotic drugs are used increasingly in patient groups at greater bleeding risk. The objective of this document is to guide healthcare professionals on the management of patients receiving antithrombotic drugs who experience significant bleeding or who require emergency surgery or an invasive procedure. Criteria used to quote levels and grades of evidence are as outlined in. The guideline was then reviewed by a sounding board of approximately 50 UK haematologists, the BCSH and the British Society for Haematology Committee and comments incorporated where appropriate. The writing group produced the draft guideline which was subsequently revised by consensus by members of the Haemostasis and Thrombosis task Force of the British Committee for Standards in Haematology (BCSH). Identified papers were also searched for additional references. The MEDLINE and EMBASE databases were searched systematically for publications in English from 1966 to June 20 to June 2011 respectively, using the following strategy: Approved and proprietary names of the antithrombotic agents described in the guideline were combined with terms relating to antidote, reversal, haemorrhage, (activated) prothrombin complex concentrate, factor VIII inhibitor bypass activity (FEIBA), Beriplex, Octaplex, recombinant activated factor VII (rFVIIa), Novoseven, fresh frozen plasma, tranexamic acid, antifibrinolytic, platelet transfusion, and desmopressin. The guideline writing group was selected to be representative of UK-based medical experts.

Antidote coumadin