Direct-Acting Oral Anticoagulants in Critically Ill Patients

Parth Rali, Andrew Gangemi, Aimee Moores, Kerry Mohrien, Lisa Moores*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

The direct-acting oral anticoagulants (DOACs) have been increasingly used over vitamin K antagonists in recent years because they do not require monitoring and have an immediate anticoagulation effect. In general, DOACs have exhibited a better safety profile and noninferiority for prophylaxis and treatment of venous thromboembolism (VTE) and stroke prevention in patients with atrial fibrillation compared with vitamin K antagonists in the non-ICU population; whether this finding holds true in patients who are critically ill remains unknown. The current review addresses the role of DOACs in special ICU populations, use of these agents for VTE prophylaxis, perioperative management of DOACs, drug monitoring, and potential drug interactions of DOACs in critically ill patients. Adverse events and available reversal agents for DOACs are also discussed.

Original languageEnglish
Pages (from-to)604-618
Number of pages15
JournalChest
Volume156
Issue number3
DOIs
StatePublished - Sep 2019
Externally publishedYes

Keywords

  • antithrombotic therapy
  • critical care
  • drugs

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