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Erschienen in: Notfall +  Rettungsmedizin 3/2017

12.04.2017 | CME

Nicht-Vitamin-K-abhängige orale Antikoagulanzien

Notfallmanagement bei Patienten mit Blutungen unter oraler Antikoagulation

verfasst von: Priv.-Doz. Dr. med. J. Koscielny, Dr. C. Rosenthal, Prof. Dr. C. von Heymann

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 3/2017

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Zusammenfassung

Trotz des breiten Einsatzes nicht-Vitamin-K-abhängiger oraler Antikoagulanzien (NOAK) sowie Empfehlungen von Zulassungsbehörden und interdisziplinären Expertengremien zum Umgang in der Blutungssituation unter NOAK-Antikoagulation besteht insbesondere in Krankenhäusern ohne hämostaseologischen Schwerpunkt große Handlungsunsicherheit. Bei aus klinischer Sicht leichten Blutungen sind die medizinische Überwachung dieser Patienten und die Verzögerung der nächsten Einnahme oder das passagere Absetzen anzuraten. Bei mittelschweren bis schweren Blutungen richten sich die primären Maßnahmen auf die Stabilisierung der Herz-Kreislauf-Funktion und parallel auf die Behandlung, je nach Lokalisation des Blutungsherdes. Vital bedrohliche, z. B. intrakranielle Blutungen erfordern neben den Maßnahmen der hämodynamischen Stabilisierung ein spezielles Hämostasemanagement, das vorwiegend klinisch orientiert sein sollte.
Fußnoten
1
C „congestive heart failure“ (Herzinsuffizienz), H Hypertension, A 2 Alter ≥75 Jahre (doppelt), D Diabetes mellitus, S2 „stroke“ (Schlaganfall; doppelt), transitorische ischämische Attacke oder Thromboembolie, V vaskuläre Erkrankungen wie periphere arterielle Verschlusskrankheit oder Herzinfarkt, A Alter 65 bis 74 Jahre, Sc „sex category“ (weibliches Geschlecht).
 
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Metadaten
Titel
Nicht-Vitamin-K-abhängige orale Antikoagulanzien
Notfallmanagement bei Patienten mit Blutungen unter oraler Antikoagulation
verfasst von
Priv.-Doz. Dr. med. J. Koscielny
Dr. C. Rosenthal
Prof. Dr. C. von Heymann
Publikationsdatum
12.04.2017
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 3/2017
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-017-0289-3