Background
Below is a very brief summary of small portion of the Joint ESAIC/ESRA guidelines, 2022.
Drug/Dose |
Time from drug intake to intervention |
Target lab value at intervention |
VKA |
Until target lab value | INR normal |
DXA low |
24 h rivaroxaban, edoxaban (30 h if CrCl <30 ml/min), 36 h apixaban | No testing |
DXA high |
72 h or until target laboratory value (until target laboratory value if CrCl <30 ml/min) | DXA level <30 ng/ml (alternative: anti-Xa 0.1 IU/ml) |
LMWH low < 50 IU anti-Xa/kg/day, enoxaparin 40mg/day |
12 h (24 h if CrCl <30 ml/min) | No testing |
LMWH high |
24 h (48 h if CrCl <30 ml/min) or until target lab value (especially if CrCl <30 ml/min) | Anti-Xa ≤ 0.1 IU/ml |
UFH low |
4 h | No testing |
UFH high |
Until target lab value (6 hrs if IV, 12 h if CS) | aPTT or anti-Xa or ACT in normal range |
Aspirin low |
0 | No testing |
Aspirin high |
3 days(in normal plts count) to 7 days | Consider platelet fxn tests |
P2Y12 inhibitor |
5 days ticagrelor 5 to 7 days clopidogrel 7 days prasugrel or until target laboratory value |
|
Aspirin low + anticoagulant |
Aspirin: 0 + time interval of specific anticoagulant |
Specific lab test for combined anticoagulant |
Aspirin low and antiplatelet |
Aspirin: 0 and time interval of specific antiplatelet drug | Consider specific lab test for combined antiplatelet drug |
Links
- Eur J Anaesthesiol 2022; 39:100–132