eMedicine Specialties > Perioperative Care > Perioperative Care
Perioperative Anticoagulation Management: Multimedia
Updated: Nov 19, 2009
Multimedia
![]() | Media file 1: Perioperative anticoagulation management. Low molecular weight heparin, prophylactic doses, and therapeutic doses. |
![]() | Media file 2: Which patients on warfarin should receive heparin bridging before surgery? Adapted from Cleveland Clinic Journal. |
![]() | Media file 3: Protocol for low molecular weight heparin as a bridge to surgery in patients on warfarin. Adapted from Cleveland Clinic Journal. |
More on Perioperative Anticoagulation Management |
| References |
| Further Reading |
References
[Best Evidence] Wijeysundera DN, Karkouti K, Rao V, et al. N-acetylcysteine is associated with increased blood loss and blood product utilization during cardiac surgery. Crit Care Med. Jun 2009;37(6):1929-34. [Medline].
Douketis JD, Berger PB, Dunn AS, et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. Jun 2008;133(6 suppl):299S-339S. [Medline]. [Full Text].
Turna B, Stein RJ, Smaldone MC, et al. Safety and efficacy of flexible ureterorenoscopy and holmium:YAG lithotripsy for intrarenal stones in anticoagulated cases. J Urol. Apr 2008;179(4):1415-9. [Medline].
Law SK, Song BJ, Yu F, et al. Hemorrhagic complications from glaucoma surgery in patients on anticoagulation therapy or antiplatelet therapy. Am J Ophthalmol. Apr 2008;145(4):736-746. [Medline].
Kearon C. Perioperative management of long-term anticoagulation. Semin Thromb Hemost. 1998;24 suppl 1:77-83. [Medline].
Jaffer AK, Brotman DJ, Chukwumerije N. When patients on warfarin need surgery. Cleve Clin J Med. Nov 2003;70(11):973-84. [Medline].
Madura JA, Rookstool M, Wease G. The management of patients on chronic Coumadin therapy undergoing subsequent surgical procedures. Am Surg. Jul 1994;60(7):542-6; discussion 546-7. [Medline].
Kraai EP, Lopes RD, Alexander JH, Garcia D. Perioperative management of anticoagulation: guidelines translated for the clinician. J Thromb Thrombolysis. Jul 2009;28(1):16-22. [Medline].
Scharf RE. Management of bleeding in patients using antithrombotic agents. Hamostaseologie. Sep 2009;29(4):388-98. [Medline].
Tanaka KA, Key NS, Levy JH. Blood coagulation: hemostasis and thrombin regulation. Anesth Analg. May 2009;108(5):1433-46. [Medline].
American College of Chest Physicians. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. 2004;126(3 suppl):214S -215S.
American College of Chest Physicians. Proceedings of the American College of Chest Physicians 5th Consensus on Antithrombotic Therapy. 1998. Chest. Nov 1998;114(5 Suppl):439S-769S. [Medline].
Douketis JD. Perioperative anticoagulation management in patients who are receiving oral anticoagulant therapy: a practical guide for clinicians. Thromb Res. Oct 1 2002;108(1):3-13.
Garcia DA, Regan S, Henault LE, et al. Risk of thromboembolism with short-term interruption of warfarin therapy. Arch Intern Med. Jan 14 2008;168(1):63-9. [Medline].
Jafri SM. Periprocedural thromboprophylaxis in patients receiving chronic anticoagulation therapy. Am Heart J. Jan 2004;147(1):3-15. [Medline].
Lanzat M, Danna AT, Jacobson DS. New protocols for perioperative management of podiatric patients taking oral anticoagulants. J Foot Ankle Surg. Jan-Feb 1994;33(1):16-20. [Medline].
O'Donnell M, Kearon C. Perioperative management of oral anticoagulation. Clin Geriatr Med. Feb 2006;22(1):199-213, xi. [Medline].
Rutherford R. Fundamental therapeutic and technical consideration. In: Vascular Surgery. Philadelphia, Pa: WB Saunders Company; 1995.
Further Reading
Related eMedicine Topics
- Anticoagulants and Thrombolytics in Pregnancy [in the Cardiology section]
- Hypercoagulability - Hereditary Thrombophilia and Lupus Anticoagulants Associated With Venous Thrombosis and Emboli [in the Hematology section]
- Perioperative DVT Prophylaxis
- Stroke Anticoagulation and Prophylaxis [in the Neurology section]
Clinical Trials
- Bridge or Continue Coumadin for Device Surgery Randomized Controlled Trial
- Evicel Study on the Peri-operative Bleeding in Total Knee Prothesis Surgery
- Perioperative Coagulation Management in Cardiac Surgery
Clinical Guidelines
- Antithrombotic therapy supplement. Institute for Clinical Systems Improvement - Private Nonprofit Organization. 2001 Sep (revised 2007 Aug). 64 pages. [NGC Update Pending] NGC:005971
- Guidelines on oral anticoagulation (warfarin): third edition - 2005 update. British Committee for Standards in Haematology - Professional Association. 2006 Feb. 9 pages. NGC:006187
- The perioperative management of antithrombotic therapy. American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). American College of Chest Physicians - Medical Specialty Society. 2008 Jun. 41 pages. NGC:006671
Keywords
perioperative anticoagulation management, anticoagulation medication, antithrombotic therapy, Coumadin therapy, warfarin therapy, deep venous thrombosis, DVT, pulmonary embolism, PE, antithrombin III deficiency, ATIII deficiency, protein C deficiency, protein S deficiency,
thromboembolism, venous thromboembolic disease, arterial thromboembolic disease, prosthetic heart valves, atrial fibrillation, congestive cardiomyopathies, mural cardiac thrombus, acute myocardial infarction, mitral valve disease, disseminated intravascular coagulation, vascular grafts, vascular shunts, vascular bypasses





