Antagonisation des héparines et des nouveaux anticoagulants

摘要: Even with unfractionated heparin or derivates, the reversal of pharmacologic anticoagulation is crucial in anticoagulated patients developing a life-threatening bleeding scheduled for an emergency procedure. The antagonisation well codified: each milligram protamine sulfate antagonizes 100 IU heparin. Measurement thrombin time reflects anti-IIa effect and has to be monitored immediately 1hour after injection protamine. required dose depends on dosage LMWH administration, although no clinical study supports these data. To date, there effective antidote new anticoagulants (fondaparinux other pentasaccharides, direct inhibitors, anti-Xa inhibitors). Some preliminary studies suggest effectiveness recombinant activated factor VII pentasaccharides not Prothrombin Complex Concentrates oral agents. Therefore, while characteristics could increase comfort improve compliance, their development needs ascertain lack complications need safe antidote.