Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery

Purpose. To report the ability to remove serum dabigatran using continuous renal replacement therapy (CRRT) in a patient with life-threatening bleeding. Summary. A 77-year-old female with history of atrial fibrillation who takes dabigatran for stroke prevention presented with abdominal pain. Patient...

Full description

Saved in:
Bibliographic Details
Main Authors: Sara E. Parli, Melissa L. Thompson Bastin, Daniel A. Lewis
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2016/9692568
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849404907621187584
author Sara E. Parli
Melissa L. Thompson Bastin
Daniel A. Lewis
author_facet Sara E. Parli
Melissa L. Thompson Bastin
Daniel A. Lewis
author_sort Sara E. Parli
collection DOAJ
description Purpose. To report the ability to remove serum dabigatran using continuous renal replacement therapy (CRRT) in a patient with life-threatening bleeding. Summary. A 77-year-old female with history of atrial fibrillation who takes dabigatran for stroke prevention presented with abdominal pain. Patient was found to have bleeding and possible mesenteric ischemia and was taken to the operating room and had continued bleeding postoperatively. CRRT was initiated for the removal of any remaining dabigatran, with serum dabigatran levels collected to evaluate removal of dabigatran with CRRT. This patient had an increased dabigatran level prior to intervention, which decreased to an undetectable level after use of CRRT. Greater than 80% of the drug was removed due to 4 hours of CRRT and residual kidney function. Reversal of dabigatran is an area of current research with recent FDA approval of idarucizumab for use. Conclusion. Bleeding may occur as a result of the use of dabigatran and change in patient’s clinical condition. Use of CRRT may be an option in removing serum dabigatran in the case of a life-threatening bleed.
format Article
id doaj-art-49854f6705b24615976ac8f06951bdac
institution Kabale University
issn 2090-6420
2090-6439
language English
publishDate 2016-01-01
publisher Wiley
record_format Article
series Case Reports in Critical Care
spelling doaj-art-49854f6705b24615976ac8f06951bdac2025-08-20T03:36:48ZengWileyCase Reports in Critical Care2090-64202090-64392016-01-01201610.1155/2016/96925689692568Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent SurgerySara E. Parli0Melissa L. Thompson Bastin1Daniel A. Lewis2Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY 40536, USADepartment of Pharmacy Services, University of Kentucky HealthCare, Lexington, KY 40536, USADepartment of Pharmacy Services, South Pointe Hospital, Cleveland Clinic, Cleveland, OH 44195, USAPurpose. To report the ability to remove serum dabigatran using continuous renal replacement therapy (CRRT) in a patient with life-threatening bleeding. Summary. A 77-year-old female with history of atrial fibrillation who takes dabigatran for stroke prevention presented with abdominal pain. Patient was found to have bleeding and possible mesenteric ischemia and was taken to the operating room and had continued bleeding postoperatively. CRRT was initiated for the removal of any remaining dabigatran, with serum dabigatran levels collected to evaluate removal of dabigatran with CRRT. This patient had an increased dabigatran level prior to intervention, which decreased to an undetectable level after use of CRRT. Greater than 80% of the drug was removed due to 4 hours of CRRT and residual kidney function. Reversal of dabigatran is an area of current research with recent FDA approval of idarucizumab for use. Conclusion. Bleeding may occur as a result of the use of dabigatran and change in patient’s clinical condition. Use of CRRT may be an option in removing serum dabigatran in the case of a life-threatening bleed.http://dx.doi.org/10.1155/2016/9692568
spellingShingle Sara E. Parli
Melissa L. Thompson Bastin
Daniel A. Lewis
Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery
Case Reports in Critical Care
title Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery
title_full Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery
title_fullStr Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery
title_full_unstemmed Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery
title_short Use of Continuous Renal Replacement Therapy for Removal of Dabigatran in a Patient in Need of Emergent Surgery
title_sort use of continuous renal replacement therapy for removal of dabigatran in a patient in need of emergent surgery
url http://dx.doi.org/10.1155/2016/9692568
work_keys_str_mv AT saraeparli useofcontinuousrenalreplacementtherapyforremovalofdabigatraninapatientinneedofemergentsurgery
AT melissalthompsonbastin useofcontinuousrenalreplacementtherapyforremovalofdabigatraninapatientinneedofemergentsurgery
AT danielalewis useofcontinuousrenalreplacementtherapyforremovalofdabigatraninapatientinneedofemergentsurgery