Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement.
Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and implementation gaps remain. As data emerge regarding innovative approaches to therapy and real-world evidence associated with the actual use of reversal and replacement agents, healthcare professionals need to be aware of the latest publications which utilize real-world data in specific life-threatening bleeds in anticoagulated patients.
This program focuses on the role of reversal agents in the presence of life-threatening bleeds while on an anticoagulant. It covers the most recent key real-world data published relative to the use of reversal or repletion strategies in anticoagulated patients.
Please stay tuned for additional content to this program available for credit. MedEd On The Go will track the episodes you watch and provide you with the option to claim credit once you have reached the level of participation needed in order to claim. The maximum amount of credits available for the entire activity is 1.5