[The implication of a direct antithrombine in the appearance of (serious) postoperative acute respiratory distress].
We present the case of a 73-year-old man, operated on for paralyzing sciatica, who displayed acute postoperative respiratory distress and intra-alveolar haemorrhage following the administration of dabigatran etexilate, a new oral antithrombin used in the prevention of venous thromboembolism. This serious incident occurred in a patient who had a 20-year history of chronic thrombocytopenia (platelet level at 100G/l) and a heparin-induced thrombocytopenia and in whom no other aetiology was found (tuberculosis, pneumo-renal syndrome, etc.). The postoperative prevention of thromboembolic events in a patient with high risk bleeding requires intensive monitoring, notably, when prescribing new drugs such as new anticoagulant agents.
Hanf
W
W
Service de réanimation, CHG de Valence, boulevard du Maréchal-Juin, Valence cedex 9, France. william.hanf@hotmail.fr
Duntze
J
J
Hida
H
H
Blanc
Q
Q
Reynaud
C
C
D000208:Acute Disease; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D000991:Antithrombins / Q000009:adverse effects*; D001562:Benzimidazoles / Q000009:adverse effects*; D000069604:Dabigatran; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000139:chemically induced*; D011725:Pyridines / Q000009:adverse effects*; D012128:Respiratory Distress Syndrome / Q000139:chemically induced*; D012720:Severity of Illness Index
D000925:Anticoagulants; D000991:Antithrombins; D001562:Benzimidazoles; D011725:Pyridines; D000069604:Dabigatran