IBCC Episode 52 Anticoagulation Reversal

In this episode of The Internet Book of Critical Care Podcast, Josh and Adam Thomas discuss anticoagulation reversal, covering scenarios from urgent, life-threatening bleeds to non-urgent situations with super-therapeutic INRs. They delve into reversing Warfarin using IV Vitamin K and PCC or FFP, address nuances of DOACs (dabigatran and 10A inhibitors) including the use of reversal agents like Idaracisumab and Adnexit Alpha, and explore thrombolytics like TPA, including their effects and reversal strategies. The hosts also discuss anti-platelet agent reversal, highlighting the limited effectiveness of platelet transfusions in certain cases and the potential role of TXA. They conclude with pre-procedure coagulation management for common ICU procedures like central lines, pleural procedures, and paracentesis, emphasizing the importance of ultrasound guidance and avoiding aggressive pre-procedure coagulation reversal.