Abstract:
:Interruption of an ongoing therapy with vitamin K antagonists (VKAs) is necessary in almost all patients undergoing major surgery. The purpose of the following expert recommendations is to provide easy to use guidance for the periprocedural management of patients on VKAs based on current evidence from the literature. Management of anticoagulation during the time of interruption of VKAs is based on balancing the thromboembolic (TE) risk of underlying conditions against the bleeding risk of the surgical procedure. VKAs should be stopped 3–7days prior to surgery. Low molecular weight heparin (LMWH) is used to cover (“bridge”) the progressive pre-operative loss of anticoagulation and the slow post-operative onset of anticoagulant activity of VKAs. Patients with high risk of TE should receive a therapeutic dose of LMWH, patients with a moderate risk of TE should receive half of this dose. Patients with a low risk of TE do not need bridging therapy with LMWH. In case of an uneventful postoperative course, patients with a therapeutic pre-operative dose should be treated post-operatively with the same dose, starting on day 4 in case of major surgery and on day 2 in case of minor procedures. Patients with a half-therapeutic preoperative dose should be treated post-operatively with the same dose, starting on day 3 in case of major surgery and on day 1 in case of minor procedures. Therapy with VKAs should be re-instituted on the second post-operative day based on the preoperative dosage. Procedure-related post-operative thromboprophylaxis should be given irrespective of these recommendations on days without “bridging” anticoagulation.
journal_name
Wien Klin Wochenschrjournal_title
Wiener klinische Wochenschriftauthors
Watzke H,Metzler H,Weltermann A,Marschang P,Brodmann M,Lang W,Pabinger-Fasching I,Mahla E,Kozek-Langenecker S,Guschmann M,Huber Kdoi
10.1007/s00508-013-0390-7subject
Has Abstractpub_date
2013-07-01 00:00:00pages
412-20issue
13-14eissn
0043-5325issn
1613-7671journal_volume
125pub_type
杂志文章abstract::Sonography should be routinely used for clinical follow up of patients with prosthetic grafts replacing the abdominal aorta and iliac vessels. 112 patients were investigated and the normal findings as well as pathological changes following aortic graft implantation are described and the difference between Dacron and P...
journal_title:Wiener klinische Wochenschrift
pub_type: 杂志文章
doi:
更新日期:1985-03-15 00:00:00
abstract::Systemic lupus erythematosus (SLE) is a heterogeneous disease with a vast variety of clinical manifestations. Timely diagnosis is important for gaining access to specific therapy and care. In this survey, we asked SLE patients with an established diagnosis to report about their personal history and their daily life wi...
journal_title:Wiener klinische Wochenschrift
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abstract::Recombinant human erythropoietin (r-HuEPO) was administered in 4 lung transplant recipients to treat chronic anemia beyond the immediate postoperative period. There were 2 males and 2 females with a mean age of 38 years (range 22-49). None of the patients had major infection or rejection problems, and no blood product...
journal_title:Wiener klinische Wochenschrift
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
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journal_title:Wiener klinische Wochenschrift
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更新日期:2001-08-16 00:00:00
abstract:AIM:Sleep disordered breathing (SDB) is an inevitable complication of progressive neuromuscular disorders (NMD). Aim of the study was to prospectively investigate the impact of three months of non-invasive ventilation (NIV) on sleep and SDB-associated symptoms in children and adolescents with advanced NMD. METHODS:Twe...
journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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更新日期:1990-08-03 00:00:00
abstract::Systolic and diastolic left ventricular function was assessed by M-mode and pulsed Doppler echocardiography in 10 young type I diabetic patients without late complications and maximal diabetes duration of 5 years and in 10 healthy persons. Fractional shortening, a measure of systolic ventricular function, was signific...
journal_title:Wiener klinische Wochenschrift
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更新日期:1990-02-02 00:00:00
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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doi:
更新日期:1996-01-01 00:00:00
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journal_title:Wiener klinische Wochenschrift
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doi:
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journal_title:Wiener klinische Wochenschrift
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doi:
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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doi:
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journal_title:Wiener klinische Wochenschrift
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更新日期:2014-09-01 00:00:00
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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journal_title:Wiener klinische Wochenschrift
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更新日期:1995-01-01 00:00:00
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journal_title:Wiener klinische Wochenschrift
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doi:
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journal_title:Wiener klinische Wochenschrift
pub_type: 杂志文章
doi:
更新日期:1999-04-09 00:00:00