What question did this study set out to answer?

To describe clinical management and evaluate reversal interventions for life-threatening dabigatran-associated bleeding exacerbated by acute renal failure.

November 16, 2012Journal of Pharmacy Practice

Treatment of Dabigatran-Associated Bleeding

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Why the study?

Does continuous venovenous hemodialysis improve dabigatran-associated bleeding in patients with acute kidney injury?

Population

1 84-year-old male with acute kidney injury who developed life-threatening gastrointestinal and surgical…

Design

Case_report

Authors

LHLisa HarinsteinCenter for Drug Evaluation and Research JMJoseph MorganCleveland Clinic NRNicholas RussoHarvard University

Discussion

Member takes

Implication

May support CVVHD consideration in refractory dabigatran bleeding with AKI; hypothesis-generating and requires prospective validation.

Key Points

To describe clinical management and evaluate reversal interventions for life-threatening dabigatran-associated bleeding exacerbated by acute renal failure.
Evaluated an 84-year-old male with acute kidney injury who experienced life-threatening gastrointestinal and surgical bleeding during dabigatran therapy.
Assessed adverse drug causality using the Naranjo scale and administered fresh frozen plasma, cryoprecipitate, recombinant factor VIIa, and continuous venovenous hemodialysis.
Administration of fresh frozen plasma, recombinant factor VIIa, and cryoprecipitate produced negligible clinical response or hemostatic control.
Continuous venovenous hemodialysis resulted in progressive clinical improvement and stabilization of dabigatran-associated bleeding.

Structured PICO

Does continuous venovenous hemodialysis improve dabigatran-associated bleeding in patients with acute kidney injury?

Population

1 84-year-old male with acute kidney injury who developed life-threatening gastrointestinal and surgical site bleeding secondary to dabigatran accumulation

Intervention

Continuous venovenous hemodialysis

Outcome

Reversal of dabigatran-associated bleedingsafety

Continuous venovenous hemodialysis may be an effective initial treatment for dabigatran-associated bleeding, particularly when standard reversal agents fail.

Cite This Study

Harinstein et al. (2012) studied this question.

synapsesocial.com/papers/6a70f230fe4101aa97e0620b https://doi.org/10.1177/0897190012465955

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Treatment of Dabigatran-Associated Bleeding

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Treatment of Dabigatran-Associated Bleeding

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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