title: Optimal Reversal of Novel Anticoagulants in Trauma.
abstract: The incidence of patients with trauma on novel oral anticoagulants (NOACs) for the treatment of thromboembolic disorders is increasing. In severe bleeding or hemorrhage into critical spaces, urgent reversal of this underlying pharmacologic coagulopathy becomes paramount. Optimal reversal strategy for commonly used NOACs is still evolving. Basic tenets of evaluation of patients with trauma and resuscitation remain the same. Clinical outcomes data in bleeding human patients with trauma are lacking, but are needed to establish efficacy and safety in these treatments. This article summarizes the available evidence and provides the optimal reversal strategy for bleeding patients with trauma on NOACs.
authors.affiliation: Department of Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 South Greene Street, T1R53, Baltimore, MD 21201, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Weinberger
authors.affiliation: Department of Surgery, Christiana Care Health System, Sidney Kimmel School of Medicine, Thomas Jefferson University, 4755 Ogletown-Stanton Road, Suite 1320, Wilmington, DE 19718, USA. Electronic address: MCipolle@christianacare.org.
authors.forename: Mark
authors.initials: M
authors.lastname: Cipolle
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000188:drug therapy*; D006470:Hemorrhage / Q000139:chemically induced* / Q000628:therapy*; D006801:Humans; D014947:Wounds and Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*
chemical_list: D000925:Anticoagulants
keywords: Anticoagulants in trauma; Coagulopathy of trauma; NOACs; Novel anticoagulants; Reversal agents