Aktuelle Therapieoptionen bei (schweren) gastrointestinalen Blutungen

Zusammenfassung

Mit Idarucizumab steht erstmals ein spezifisches Antidot zur Antagonisierung der Dabigatran-Wirkung bei schwerer Blutungskomplikation unter direkten oralen Antikoagulanzien (DOAK) zur Verfügung. In der endoskopischen Therapie schwerer gastrointestinaler Blutungen finden topisch aufzutragende Substanzen und neue Hämostase-Clips Beachtung in den neu erschienenen Leitlinien. Besonders bei rezidivierenden Ulkusblutungen können die neu entwickelten Clips eine Hämostase erreichen und eine Operation verhindern. Bei Patienten mit koronarer Herzkrankheit sollte ein liberaleres Transfusionsregime angewendet werden.

Abstract

With Idarucizumab, a specific antidote to antagonize the effect of dabigatran, is now available in severe bleeding complications under directly oral anticoagulants (DOAC). In endoscopic treatment of severe gastrointestinal bleeding are alternative treatment options also available with hemostasis sprays and new hemostasis clips. Especially in recurrent ulcer bleedings, the newly developed clips can achieve hemostasis and prevent an operational procedure. In patients with coronary heart disease, a liberal transfusion regimen should be considered.

Schlüsselwörter

direkte orale Antikoagulanzien - Idarucizumab - Hämostase-Sprays - OTSC^® - Transfusionsregime

Keywords

non-vitamin-K oral anticoagulants - Idarucizumab - hemostasis sprays - OTSC^® - blood transfusion regimen

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