Thromboelastometry-guided anticoagulation reversal in a patient with ventricular assist device with intracranial hemorrhage. Journal Article

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Authors: Bonderski, VA; Portillo, J; Sharp, L; Rech, MA
Article Title: Thromboelastometry-guided anticoagulation reversal in a patient with ventricular assist device with intracranial hemorrhage.
Abstract: Intracranial hemorrhage (ICH) is a known complication in patients with ventricular assist devices (VAD). We present a case of a 42-year-old male with a VAD and on warfarin who presented to the emergency department with ICH necessitating anticoagulant reversal. An attenuated dose of 15 units/kg of 4-factor prothrombin complex-concentrates (4F-PCC) was given and the patient's coagulation profile was subsequently assessed using rotational thromboelastometry (ROTEM®) to determine appropriateness of reversal. ROTEM® analysis showed adequate reversal at the time of assessment and the patient ultimately returned home without further functional deficits, highlighting the role of ROTEM® to guide anticoagulation reversal in the VAD patient population.
Journal Title: The American Journal of Emergency Medicine
ISSN: 1532-8171; 0735-6757
Publisher: Unknown  
Date Published: 2020