Hi,
What is bridging and when and where is it needed?
Thanks,
Tom
What is bridging and when and where is it needed?
Thanks,
Tom
Bridging???
- Thread starter Cooker
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K
Karlynn
Bridging is when you are taken off your Coumadin and given a short acting anticoagulent such as Lovenox or Heparin. This is done if you are going to have a surgical procedure or test that puts you at risk of significant bleeding if it is done while you are anticoagulated.
Coumadin is a very slow-acting medication and takes 3 days to get into your system and 3 days to get out. Lovenox and Heparin have about a 12 hours cycle. By having you stop Coumadin (usually 3 to 5 days prior to a procedure) and starting Lovenox or Heparin they are able to have you stop them w/in a day of the surgery and have you at normal coagulation for a brief time for the procedure.
Usually, once the procedure is over, you are started back on the bridging, along with the Coumadin until your INR is back to theraputic level.
Coumadin is a very slow-acting medication and takes 3 days to get into your system and 3 days to get out. Lovenox and Heparin have about a 12 hours cycle. By having you stop Coumadin (usually 3 to 5 days prior to a procedure) and starting Lovenox or Heparin they are able to have you stop them w/in a day of the surgery and have you at normal coagulation for a brief time for the procedure.
Usually, once the procedure is over, you are started back on the bridging, along with the Coumadin until your INR is back to theraputic level.
Thanks. Is there an increased risk of stroke?
Tom
Tom
R
RandyL
Stopping coumadin and bridgeing
Stopping coumadin and bridgeing
I will start my reply with a simple statement. " I am not an expert and I am not giving advice, only what I have done personally". This ia a very tricky subject on the best way to bridge for a procedure.
Just recently in the past 2 months I have had to stop my coumadin 3 times for an epidural procedure in my lower back. This procedure has become very easy with modern technology however a drop of blood in your spinal canal can cause paralysis so it is important not be on any anticouaglant meds or even aspirin for that matter.
I asked for advice from many places on how to bridge for this procedure which included VR.com, my Cardiologist, the Radiologist performing the procedure, and my Valve Surgeon. I followed my valve surgeon's advice and it seemed to work for me. ( I'm alive to tell about it.LOL)
I stopped my coumadin 4-5 days beore the procedure and right after the procedure I started my coumadin. My normal dose is 10mg/day and I was advised to take 15 mg the first 2 days(kind of a jump start) and then my normal 10mg/day. I started Lovenox shots the day after the procedure and continued them until I was therapeutic on coumadin. This usually took 6-7 days before I could stop the Lovenox shots.
Probably the best way to bridge is to go into the hospital and be on Heparin and then stay there after the procedure on heparin until you are therapeutic on coumadin.I could not take time off to be in the hospital for this 10 minute procedure. You could also stop your coumadin and take the Lovenox shots 2-3 days after you stop so your still protected but then you would have to stop ther Lovenox 24 hours before the procedure to be safe. I felt that I was only at risk and extra day by not taking the Lovenox shots before the procedure.
Find out all the facts you need and take the advice of someone you totally trust to make your decision, in this case it was my valve surgeon for my Cardiologist told me to ask the Radiologist who told me to ask the Cardiologist.
Go Figure
Hope this helps. Good Luck
Stopping coumadin and bridgeing
I will start my reply with a simple statement. " I am not an expert and I am not giving advice, only what I have done personally". This ia a very tricky subject on the best way to bridge for a procedure.
Just recently in the past 2 months I have had to stop my coumadin 3 times for an epidural procedure in my lower back. This procedure has become very easy with modern technology however a drop of blood in your spinal canal can cause paralysis so it is important not be on any anticouaglant meds or even aspirin for that matter.
I asked for advice from many places on how to bridge for this procedure which included VR.com, my Cardiologist, the Radiologist performing the procedure, and my Valve Surgeon. I followed my valve surgeon's advice and it seemed to work for me. ( I'm alive to tell about it.LOL)
I stopped my coumadin 4-5 days beore the procedure and right after the procedure I started my coumadin. My normal dose is 10mg/day and I was advised to take 15 mg the first 2 days(kind of a jump start) and then my normal 10mg/day. I started Lovenox shots the day after the procedure and continued them until I was therapeutic on coumadin. This usually took 6-7 days before I could stop the Lovenox shots.
Probably the best way to bridge is to go into the hospital and be on Heparin and then stay there after the procedure on heparin until you are therapeutic on coumadin.I could not take time off to be in the hospital for this 10 minute procedure. You could also stop your coumadin and take the Lovenox shots 2-3 days after you stop so your still protected but then you would have to stop ther Lovenox 24 hours before the procedure to be safe. I felt that I was only at risk and extra day by not taking the Lovenox shots before the procedure.
Find out all the facts you need and take the advice of someone you totally trust to make your decision, in this case it was my valve surgeon for my Cardiologist told me to ask the Radiologist who told me to ask the Cardiologist.
Go Figure
Hope this helps. Good Luck
K
Karlynn
cooker said:
It's my understanding that there is an increased risk for stroke in the small window between when the bridging is stopped and when ACT is started up again. We have many members here who have had to bridge for one reason or another. So far I have not.
One thing you would want to be sure and do is check and see what correct protocol is for any procedure being considered. Some doctors want patients coagulated for the simplest of procedures because they fear bleeding more than stroke and as we know "it's easier to replace blood cells than brain cells."
