title: New oral anticoagulants in severe trauma patients: enemy at the gates?
abstract: The high incidence of trauma, especially in elderly people anticoagulated with new oral anticoagulants (NOAs), has become a major challenge, particularly in critical situations with life-threatening bleeding. Under these circumstances, urgent NOA reversion becomes mandatory. Prothrombin complex has become a frequent indication in critical situations in which rapid reversal of anticoagulation is needed and where the use of fresh frozen plasma is limited. This study offers our point of view regarding the usefulness of NOAs, not only in the prevention of cardioembolic events but also as regards their emergent reversion in cases of severe bleeding associated to trauma.
authors.affiliation: Unidad de Neurocríticos. Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina de Sevilla (IBiS)/CSIC/Universidad de Sevilla, Sevilla, España. Electronic address: juanjoegea@hotmail.com.
authors.forename: J J
authors.initials: JJ
authors.lastname: Egea-Guerrero
authors.affiliation: Departamento de Urgencias, Hospital Universitario La Paz, IdiPAZ, Madrid, España; Unidad de Cuidados Intensivos, Hospital Universitario La Paz, IdiPAZ, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Quintana Díaz
mesh_terms: D000991:Antithrombins / Q000009:adverse effects* / Q000627:therapeutic use; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D002606:Charcoal / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D004630:Emergencies; D065427:Factor Xa Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D006470:Hemorrhage / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D010949:Plasma; D017410:Practice Guidelines as Topic; D019851:Thrombophilia / Q000150:complications / Q000188:drug therapy; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D000991:Antithrombins; D001779:Blood Coagulation Factors; D065427:Factor Xa Inhibitors; D006490:Hemostatics; D002606:Charcoal; C025667:prothrombin complex concentrates
keywords: Bleeding; Complejo concentrado de protrombina; Hemorragia; New oral anticoagulants; Nuevos anticoagulantes orales; Prothrombin complex concentrate; Reversion; Reversión; Trauma