Safe chest tube placement in a patient with tension pneumothorax receiving rivaroxaban therapy for non-valvular atrial fibrillation

Monaldi Archives for Chest Disease

Massimo Santini¹  Ester Taurino¹  Alessandro Cipriano²  Elena Venturi³  Matteo Parollo³ 

[1] Azienda Ospedaliero-Universitaria Pisana, Pisa University Hospital, Italy;Emergency Department Azienda Ospedaliero-Universitaria Pisana, Pisa;Emergency Department;

关键词: Pneumothorax;    rivaroxaban;    thoracostomy;    anticoagulants;    bleeding;   

DOI  :  10.4081/monaldi.2020.1262

来源: DOAJ

【 摘 要 】

The number of patients treated with direct oral anticoagulants is increasing worldwide. Although bleeding complications associated with direct oral anticoagulants are lower than those associated with vitamin K antagonists, the increased number of patients treated with these anticoagulants suggests that a higher absolute number of patients are at risk. Tube thoracostomy is an invasive procedure with a high risk of bleeding. To date, among direct oral anticoagulants, only dabigatran has a well-studied antidote to reverse its effects during emergency procedure or surgery. This report describes a case in which emergency placement of a tube thoracostomy, in a patient with type 2 respiratory failure due to left tension pneumothorax and receiving the anticoagulant rivaroxaban, in the pharmacokinetics phase with greater anticoagulant effect, did not result in bleeding greater than that typically encountered during such interventions. The procedure ended successfully with no acute complications.

【 授权许可】

Unknown