Monitoring of dabigatran anticoagulation and its reversal in vitro by thrombelastography.

摘要: Abstract Background Dabigatran etexilate, a pro-drug of direct thrombin inhibitor, was approved few years ago for non-valvular atrial fibrillation and deep venous thrombosis. Rapid monitoring the dabigatran level is essential in trauma bleeding patients but traditional plasma-based assays may not sufficiently display effect. Furthermore, no antidote exists reversal anticoagulant effect impossible or difficult. The present study investigated vitro on whole blood thromboelastography (TEG) its by recombinant activated factor VII prothrombin complex concentrate. Methods Blood collected from 10 healthy donors spiked with therapeutic doses to plasma concentration 200ng/ml, followed (corresponding 100μg/kg) concentrate 50IE/kg) evaluated TEG. Results Compared baseline, changed all TEG parameters hypocoagulable direction corresponding increased R time maximum rate thrombus generation, reduced angle, A5, A10, amplitude formation. Recombinant had procoagulant majority when added samples. Prothrombin appeared have even heparin content formulation neutralized heparinase. Conclusions displays presence partly reversed spiking VII.