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Neurosurgical intervention in children with ventricular assist devices: A single center case series review
CONCLUSIONS: Perioperative concerns for the anesthesiologist include VAD hemodynamic management, bleeding, VAD thrombosis, and prevention of secondary brain injury. A systematic, multidisciplinary approach to management is paramount to attain favorable outcomes.PMID:34478592 | DOI:10.1111/pan.14287
Source: Paediatric Anaesthesia - September 3, 2021 Category: Anesthesiology Authors: Jane Yu Jenna Murray Chandra Ramamoorthy Sharon Chen Sarah Lee Kathleen Ryan Katsuhide Maeda Manchula Navaratnam Source Type: research

Four-factor Prothrombin Complex Concentrate for the Management of Patients Receiving Direct Oral Activated Factor X Inhibitors
Direct oral anticoagulants (DOACs) have been approved for the prevention of stroke and systemic embolism in atrial fibrillation, treatment and secondary prevention of venous thromboembolism (VTE), and thromboprophylaxis after major orthopedic surgery. DOACs achieve anticoagulation by inhibiting specific coagulation factors; apixaban, betrixaban, edoxaban, and rivaroxaban inhibit activated factor X, whereas dabigatran inhibits thrombin (factor IIa). In contrast to vitamin K antagonists such as warfarin, DOACs have more predictable pharmacokinetics and pharmacodynamics and fewer interactions with other medications and food, ...
Source: Anesthesiology - October 15, 2019 Category: Anesthesiology Source Type: research

Perioperative venous thromboembolic disease and the emerging role of the novel oral anticoagulants: An analysis of the implications for perioperative management.
Abstract Venous thromboembolism includes 2 inter-related conditions: Deep venous thrombosis and pulmonary embolism. Heparin and low-molecular-weight heparin followed by oral anticoagulation with vitamin K agonists is the first line and current accepted standard therapy with good efficacy. However, this therapeutic strategy has many limitations including the significant risk of bleeding and drug, food and disease interactions that require frequent monitoring. Dabigatran, rivaroxaban, apixaban, and edoxaban are the novel oral anticoagulants that are available for use in stroke prevention in atrial fibrillation and f...
Source: Annals of Cardiac Anaesthesia - October 1, 2015 Category: Anesthesiology Authors: Mookadam M, Shamoun FE, Ramakrishna H, Obeid H, Rife RL, Mookadam F Tags: Ann Card Anaesth Source Type: research

New oral anticoagulants in perioperative medicine.
Abstract New oral anticoagulants (NOAC) inhibit factor Xa (Stuart-Prower factor) or factor IIa (thrombin) and are alternatives to vitamin K antagonists. Perioperative indications are deep vein thrombosis prophylaxis for prosthetic hip and knee replacement, therapeutic anticoagulation for deep vein thrombosis as well as the prophylaxis of stroke for patients with atrial fibrillation. Patients on NOACs pose multiple perioperative challenges for all medical disciplines involved. For non-emergency surgery, patients should be evaluated by an anesthesiolgist as early as possible to assess an optimal appointment for surg...
Source: Der Anaesthesist - April 4, 2014 Category: Anesthesiology Authors: Giebl A, Gürtler K Tags: Anaesthesist Source Type: research