title: Normalization of Activated Partial Thromboplastin Time Correlates with Low Levels of Dabigatran in a Patient with Severe Sepsis.
abstract: The oral anticoagulant dabigatran etexilate can be a challenge when patients need acute surgery. Sepsis and acute renal failure exacerbate the anticoagulant effect. There is no specific reversal agent for dabigatran etexilate, but it can be removed by hemodialysis. We present a case where a patient treated with dabigatran etexilate was admitted to intensive care unit with severe sepsis and acute renal failure and in need of bilateral lower limp amputation due to ischemia. The patient had severe coagulopathy and was treated with continuous venovenous hemofiltration in attempt to remove dabigatran etexilate before surgery.
authors.affiliation: Department of Anesthesia and Intensive Care, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
authors.forename: Rikke Ebenhard
authors.initials: RE
authors.lastname: Højland
authors.affiliation: Department of Anesthesia and Intensive Care, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
authors.forename: Stine Borch
authors.initials: SB
authors.lastname: Thorup
authors.affiliation: Department of Anesthesia and Intensive Care, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark.
authors.forename: Bodil Steen
authors.initials: BS
authors.lastname: Rasmussen