Ross
Well-known member
Al if you should happen to get a chance, can you highlight us on these new guidelines from Chest?
We've found this:
Finer points: Antithrombotic and Thrombolytic Therapy: ACCP Evidence-Based Clinical Practice Guidelines, 8th edition, has been published as a supplement to the June 2008 Chest. This 900-page document was developed by an international panel of 90 experts and contains the most comprehensive information on the prevention, treatment, and long-term management of thrombotic disorders. For the first time, the guidelines have an entire section (chapter 10) discussing the management of patients on antithrombotic therapy who require surgery. Among the various options, the guidelines discuss the following:
Warfarin therapy may be stopped altogether around 5 days before surgery, instead using subcutaneous low–molecular weight heparin (LMWH) or I.V. unfractionated heparin (UFH) for coverage of high-risk patients. For cost containment, LMWH should be administered on an outpatient basis, with the last dose given 24 hours before surgery.
Antiplatelet therapies such as aspirin or clopidogrel-containing drugs should be stopped 7 to 10 days before the procedure.
Patients undergoing minor dental, dermatologic, or cataract removal should continue to receive warfarin or aspirin therapy.
Patients receiving warfarin who require reversal of the anticoagulant effect for an urgent procedure should be treated with low-dose (2.5 mg to 5.0 mg) I.V. or oral vitamin K.
We've found this:
Finer points: Antithrombotic and Thrombolytic Therapy: ACCP Evidence-Based Clinical Practice Guidelines, 8th edition, has been published as a supplement to the June 2008 Chest. This 900-page document was developed by an international panel of 90 experts and contains the most comprehensive information on the prevention, treatment, and long-term management of thrombotic disorders. For the first time, the guidelines have an entire section (chapter 10) discussing the management of patients on antithrombotic therapy who require surgery. Among the various options, the guidelines discuss the following:
Warfarin therapy may be stopped altogether around 5 days before surgery, instead using subcutaneous low–molecular weight heparin (LMWH) or I.V. unfractionated heparin (UFH) for coverage of high-risk patients. For cost containment, LMWH should be administered on an outpatient basis, with the last dose given 24 hours before surgery.
Antiplatelet therapies such as aspirin or clopidogrel-containing drugs should be stopped 7 to 10 days before the procedure.
Patients undergoing minor dental, dermatologic, or cataract removal should continue to receive warfarin or aspirin therapy.
Patients receiving warfarin who require reversal of the anticoagulant effect for an urgent procedure should be treated with low-dose (2.5 mg to 5.0 mg) I.V. or oral vitamin K.
