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Laryngorhinootologie 2015; 94(S 01): S143-S152
DOI: 10.1055/s-0034-1396872
Referat
© Georg Thieme Verlag KG Stuttgart · New York

Perioperatives Hämostasemanagement bei HNO-Eingriffen

Hemostatic Management of Patients undergoing Ear-Nose-Throat-Surgery
T. Thiele
1   Abteilung Transfusionsmedizin, Institut für Immunologie und Transfusionsmedizin
,
H. Kaftan
2   Klinik und Poliklinik für Hals-Nasen-Ohrenkrankheiten, Kopf- und Halschirurgie, Universitätsmedizin Greifswald
,
W. Hosemann
2   Klinik und Poliklinik für Hals-Nasen-Ohrenkrankheiten, Kopf- und Halschirurgie, Universitätsmedizin Greifswald
,
A. Greinacher
1   Abteilung Transfusionsmedizin, Institut für Immunologie und Transfusionsmedizin
› Author Affiliations
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Publication History

Publication Date:
10 April 2015 (online)

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Zusammenfassung

Das perioperative Hämostasemanagement gewinnt auch in der Otorhinolaryngologie zunehmend an Bedeutung. Die vorliegende Übersichtsarbeit fasst den aktuellen Stand der Literatur zusammen und erläutert das perioperative Hämostasemanagement. Mit Bezug auf die HNO-Heilkunde werden die allgemeinen Prinzipien der Risikobewertung, Thromboseprophylaxe, und der Überbrückung der Antikoagulation erläutert.

Abstract

Perioperative hemostatic management is increasingly important in Otolaryngology. This review summarizes the key elements of perioperative risk stratification, thromboprophylaxis, and therapies for bridging of antithrombotic treatment. It gives a practical advise based on the current literature with an emphasis for patients undergoing ear-nose-throat surgery.

Schlüsselwörter

Antikoagulation - Thrombozytenaggregationshemmung - Thromboseprophylaxe - Blutungsrisiko - Thromboserisiko

Key words

anticoagulation - platelet inhibition - thromboprophylaxis - bleeding risk - thrombosis risk
 

  • Literatur

  • 1 Ortel TL. Perioperative management of patients on chronic antithrombotic therapy. Blood 2012; 120: 4699-4705
    CrossrefPubMedGoogle Scholar
  • 2 Koscielny J, Ziemer S, Radtke H et al. A practical concept for preoperative identification of patients with impaired primary hemostasis. Clin Appl Thromb Hemost 2004; 10: 195-204
    CrossrefPubMedGoogle Scholar
  • 3 Chee YL, Crawford JC, Watson HG, Greaves M. Guidelines on the assessment of bleeding risk prior to surgery or invasive procedures. British Committee for Standards in Haematology. Br J Haematol 2008; 140: 496-504
    CrossrefPubMedGoogle Scholar
  • 4 Kaplan EB, Sheiner LB, Boeckmann AJ et al. The usefulness of preoperative laboratory screening. JAMA 1985; 253: 3576-3581
    CrossrefPubMedGoogle Scholar
  • 5 Prim MP, De Diego JI, Jimenez-Yuste V, Sastre N, Rabanal I, Gavilan J. Analysis of the causes of immediate unanticipated bleeding after pediatric adenotonsillectomy. Int J Pediatr Otorhinolaryngol 2003; 67: 341-344
    CrossrefPubMedGoogle Scholar
  • 6 Myssiorek D, Alvi A. Post-tonsillectomy hemorrhage: an assessment of risk factors. Int J Pediatr Otorhinolaryngol 1996; 37: 35-43
    CrossrefPubMedGoogle Scholar
  • 7 Scheckenbach K, Bier H, Hoffmann TK et al. Risk of hemorrhage after adenoidectomy and tonsillectomy. Value of the preoperative determination of partial thromboplastin time, prothrombin time and platelet count. HNO 2008; 56: 312-320
    CrossrefPubMedGoogle Scholar
  • 8 Schwaab M, Hansen S, Gurr A, Dazert S. Significance of blood tests prior to adenoidectomy. Laryngorhinootologie 2008; 87: 100-106
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Eberl W, Wendt I, Schroeder HG. Preoperative coagulation screening prior to adenoidectomy and tonsillectomy. Klin Padiatr 2005; 217: 20-24
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Asaf T, Reuveni H, Yermiahu T et al. The need for routine pre-operative coagulation screening tests (prothrombin time PT/partial thromboplastin time PTT) for healthy children undergoing elective tonsillectomy and/or adenoidectomy. Int J Pediatr Otorhinolaryngol 2001; 61: 217-222
    CrossrefPubMedGoogle Scholar
  • 11 Pfanner G, Koscielny J, Pernerstorfer T et al. Preoperative evaluation of the bleeding history. Recommendations of the working group on perioperative coagulation of the Austrian Society for Anaesthesia, Resuscitation and Intensive Care. Anaesthesist 2007; 56: 604-611
    CrossrefPubMedGoogle Scholar
  • 12 Sumnig A, Grotevendt A, Westphal A, Fiene M, Greinacher A, Thiele T. Acquired hemophilia with inhibitors presenting as an emergency: misinterpretation of clotting results during direct oral anticoagulation. Dtsch Arztebl Int 2014; 111: 345-348
    PubMedGoogle Scholar
  • 13 Steiner T. Neue direkte Orale Antikoagulanzien: Was im Notfall zu beachten ist. Dtsch Arztebl International 2012; 109: A-1928-A-1930
    PubMedGoogle Scholar
  • 14 Schmitz EM, Boonen K, van den Heuvel DJ et al. Determination of dabigatran, rivaroxaban and apixaban by ultra-performance liquid chromatography – tandem mass spectrometry (UPLC-MS/MS) and coagulation assays for therapy monitoring of novel direct oral anticoagulants. J Thromb Haemost 2014; 12: 1636-1646
    CrossrefPubMedGoogle Scholar
  • 15 Knopf A, Freudelsperger L, Stark T, Scherer E. ENT surgery in patients with anticoagulants and platelet aggregation inhibitors. HNO 2014; 62: 350-357
    CrossrefPubMedGoogle Scholar
  • 16 Moreano EH, Hutchison JL, McCulloch TM, Graham SM, Funk GF, Hoffman HT. Incidence of deep venous thrombosis and pulmonary embolism in otolaryngology-head and neck surgery. Otolaryngol Head Neck Surg 1998; 118: 777-784
    CrossrefPubMedGoogle Scholar
  • 17 Garritano FG, Lehman EB, Andrews GA. Incidence of venous thromboembolism in otolaryngology-head and neck surgery. JAMA Otolaryngol Head Neck Surg 2013; 139: 21-27
    CrossrefPubMedGoogle Scholar
  • 18 Thai L, McCarn K, Stott W et al. Venous thromboembolism in patients with head and neck cancer after surgery. Head Neck 2013; 35: 4-9
    CrossrefPubMedGoogle Scholar
  • 19 Clayburgh DR, Stott W, Cordiero T et al. Prospective study of venous thromboembolism in patients with head and neck cancer after surgery. JAMA Otolaryngol Head Neck Surg 2013; 139: 1143-1150
    CrossrefPubMedGoogle Scholar
  • 20 Clayburgh D, Stott W, Kochanowski T et al. Prospective study of venous thromboembolism in patients with head and neck cancer after surgery: interim analysis. JAMA Otolaryngol Head Neck Surg 2013; 139: 161-167
    CrossrefPubMedGoogle Scholar
  • 21 Caprini JA, Arcelus JI, Reyna JJ. Effective risk stratification of surgical and nonsurgical patients for venous thromboembolic disease. Semin Hematol 2001; 38 (2 Suppl 5): 12-19
    PubMedGoogle Scholar
  • 22 Shuman AG, Hu HM, Pannucci CJ, Jackson CR, Bradford CR, Bahl V. Stratifying the risk of venous thromboembolism in otolaryngology. Otolaryngol Head Neck Surg 2012; 146: 719-724
    CrossrefPubMedGoogle Scholar
  • 23 Sherwood MW, Douketis JD, Patel MR et al. Outcomes of temporary interruption of rivaroxaban compared with warfarin in patients with nonvalvular atrial fibrillation: results from the rivaroxaban once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation (ROCKET AF). Circulation 2014; 129: 1850-1859
    CrossrefPubMedGoogle Scholar
  • 24 Gage BF, Waterman AD, Shannon W, Boechler M, Rich MW, Radford MJ. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA 2001; 285: 2864-2870
    CrossrefPubMedGoogle Scholar
  • 25 Kaatz S, Douketis JD, Zhou H, Gage BF, White RH. Risk of stroke after surgery in patients with and without chronic atrial fibrillation. J Thromb Haemost 2010; 8: 884-890
    PubMedGoogle Scholar
  • 26 Cannegieter SC, Rosendaal FR, Briet E. Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses. Circulation 1994; 89: 635-641
    CrossrefPubMedGoogle Scholar
  • 27 Douketis JD, Spyropoulos AC, Spencer FA et al. Perioperative management of antithrombotic therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): e326S-e350S
    CrossrefPubMedGoogle Scholar
  • 28 Douketis JD. Perioperative management of patients who are receiving warfarin therapy: an evidence-based and practical approach. Blood 2011; 117: 5044-5049
    CrossrefPubMedGoogle Scholar
  • 29 Sun JC, Davidson MJ, Lamy A, Eikelboom JW. Antithrombotic management of patients with prosthetic heart valves: current evidence and future trends. Lancet 2009; 374: 565-576
    CrossrefPubMedGoogle Scholar
  • 30 Brener SJ, Kereiakes DJ, Simonton CA et al. Everolimus-eluting stents in patients undergoing percutaneous coronary intervention: final 3-year results of the Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Subjects With de Novo Native Coronary Artery Lesions trial. Am Heart J 2013; 166: 1035-1042
    CrossrefPubMedGoogle Scholar
  • 31 Dangas GD, Serruys PW, Kereiakes DJ et al. Meta-analysis of everolimus-eluting versus paclitaxel-eluting stents in coronary artery disease: final 3-year results of the SPIRIT clinical trials program (Clinical Evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions). JACC Cardiovasc Interv 2013; 6: 914-922
    CrossrefPubMedGoogle Scholar
  • 32 Feres F, Costa RA, Abizaid A et al. Three vs. twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial. JAMA 2013; 310: 2510-2522
    PubMedGoogle Scholar
  • 33 Spyropoulos AC, Albaladejo P, Godier A et al. Periprocedural antiplatelet therapy: recommendations for standardized reporting in patients on antiplatelet therapy: communication from the SSC of the ISTH. J Thromb Haemost 2013; 11: 1593-1596
    CrossrefPubMedGoogle Scholar
  • 34 AWMF-Leitlinie Prophylaxe der venösen Thromboembolie (VTE) 2010
    PubMed
  • 35 Gould MK, Garcia DA, Wren SM et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2 Suppl): e227S-e277S
    CrossrefPubMedGoogle Scholar
  • 36 Sarode R, Milling Jr TJ, Refaai MA et al. Efficacy and safety of a 4-factor prothrombin complex concentrate in patients on vitamin K antagonists presenting with major bleeding: a randomized, plasma-controlled, phase IIIb study. Circulation 2013; 128: 1234-1243
    CrossrefPubMedGoogle Scholar
  • 37 Beyer-Westendorf J, Forster K, Pannach S et al. Rates, management, and outcome of rivaroxaban bleeding in daily care: results from the Dresden NOAC registry. Blood 2014; 124: 955-962
    CrossrefPubMedGoogle Scholar
  • 38 Heidbuchel H, Verhamme P, Alings M et al. EHRA practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation: executive summary. Eur Heart J 2013; 34: 2094-2106
    CrossrefPubMedGoogle Scholar
  • 39 Warkentin TE, Margetts P, Connolly SJ, Lamy A, Ricci C, Eikelboom JW. Recombinant factor VIIa (rFVIIa) and hemodialysis to manage massive dabigatran-associated postcardiac surgery bleeding. Blood 2012; 119: 2172-2174
    CrossrefPubMedGoogle Scholar
  • 40 Singh T, Maw TT, Henry BL et al. Extracorporeal therapy for dabigatran removal in the treatment of acute bleeding: a single center experience. Clin J Am Soc Nephrol 2013; 8: 1533-1539
    CrossrefPubMedGoogle Scholar
  • 41 Selleng K, Thiele T, Sumnig A, Mayerle J, Greinacher A. Dabigatran may redistribute into the vascular compartment after hemodialysis – a case report. Abstract GTH Annual Meeting 2013;
    PubMedGoogle Scholar
  • 42 Schiele F, van Ryn J, Canada K et al. A specific antidote for dabigatran: functional and structural characterization. Blood 2013; 121: 3554-3562
    CrossrefPubMedGoogle Scholar
  • 43 Lu G, DeGuzman FR, Hollenbach SJ et al. A specific antidote for reversal of anticoagulation by direct and indirect inhibitors of coagulation factor Xa. Nat Med 2013; 19: 446-451
    CrossrefPubMedGoogle Scholar
  • 44 Thiele T, Althaus K, Greinacher A. Heparin-induced thrombocytopenia. Internist (Berl) 2010; 51: 1127-1132 1134–1135
    CrossrefPubMedGoogle Scholar
  • 45 Nast A, Ernst H, Rosumeck S, Erdmann R, Jacobs A, Sporbeck B.. Risk of complications due to anticoagulation during dermatosurgical procedures: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2014;
    PubMedGoogle Scholar
  • 46 Birnie DH, Healey JS, Wells GA et al. Pacemaker or defibrillator surgery without interruption of anticoagulation. N Engl J Med 2013; 368: 2084-2093
    CrossrefPubMedGoogle Scholar
  • 47 Devereaux PJ, Mrkobrada M, Sessler DI et al. Aspirin in patients undergoing noncardiac surgery. N Engl J Med 2014; 370: 1494-1503
    CrossrefPubMedGoogle Scholar
  • 48 Li C, Hirsh J, Xie C, Johnston MA, Eikelboom JW. Reversal of the anti-platelet effects of aspirin and clopidogrel. J Thromb Haemost 2012; 10: 521-528
    CrossrefPubMedGoogle Scholar
  • 49 Zafar MU, Santos-Gallego C, Vorchheimer DA et al. Platelet function normalization after a prasugrel loading-dose: time-dependent effect of platelet supplementation. J Thromb Haemost 2013; 11: 100-106
    CrossrefPubMedGoogle Scholar
  • 50 Farid NA, Payne CD, Small DS et al. Cytochrome P450 3A inhibition by ketoconazole affects prasugrel and clopidogrel pharmacokinetics and pharmacodynamics differently. Clin Pharmacol Ther 2007; 81: 735-741
    CrossrefPubMedGoogle Scholar
  • 51 Jakubowski JA, Payne CD, Li YG et al. A comparison of the antiplatelet effects of prasugrel and high-dose clopidogrel as assessed by VASP-phosphorylation and light transmission aggregometry. Thromb Haemost 2008; 99: 215-222
    PubMedGoogle Scholar
  • 52 Korte W, Cattaneo M, Chassot PG et al. Peri-operative management of antiplatelet therapy in patients with coronary artery disease: joint position paper by members of the working group on Perioperative Haemostasis of the Society on Thrombosis and Haemostasis Research (GTH), the working group on Perioperative Coagulation of the Austrian Society for Anesthesiology, Resuscitation and Intensive Care (OGARI) and the Working Group Thrombosis of the European Society for Cardiology (ESC). Thromb Haemost 2011; 105: 743-749
    Article in Thieme ConnectPubMedGoogle Scholar
  • 53 Authors/Task Force m Windecker S, Kolh P. et al. 2014; ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2014;
    PubMedGoogle Scholar
  • 54 Sylvester DC, Coatesworth AP. Antiplatelet therapy in ENT surgery: a review. J Laryngol Otol 2012; 126: 331-336
    CrossrefPubMedGoogle Scholar
  • 55 Albaladejo P, Charbonneau H, Samama CM et al. Bleeding complications in patients with coronary stents during non-cardiac surgery. Thromb Res 2014; 134: 268-272
    CrossrefPubMedGoogle Scholar
  • 56 Savage JR, Parmar A, Robinson PJ. Antiplatelet drugs in elective ENT surgery. J Laryngol Otol 2012; 126: 886-892
    CrossrefPubMedGoogle Scholar
  • 57 Vaishnava P, Eagle KA. The yin and yang of perioperative medicine. N Engl J Med 2014; 370: 1554-1555
    CrossrefPubMedGoogle Scholar
  • 58 Vicenzi MN, Meislitzer T, Heitzinger B, Halaj M, Fleisher LA, Metzler H. Coronary artery stenting and non-cardiac surgery – a prospective outcome study. Br J Anaesth 2006; 96: 686-693
    CrossrefPubMedGoogle Scholar
  • 59 Collet JP, Himbet F, Steg PG. Myocardial infarction after aspirin cessation in stable coronary artery disease patients. Int J Cardiol 2000; 76: 257-258
    CrossrefPubMedGoogle Scholar
  • 60 Thiele T, Sumnig A, Hron G et al. Platelet transfusion for reversal of dual antiplatelet therapy in patients requiring urgent surgery: a pilot study. J Thromb Haemost 2012; 10: 968-971
    CrossrefPubMedGoogle Scholar
  • 61 Farid NA, Kurihara A, Wrighton SA. Metabolism and disposition of the thienopyridine antiplatelet drugs ticlopidine, clopidogrel, and prasugrel in humans. J Clin Pharmacol 2010; 50: 126-142
    CrossrefPubMedGoogle Scholar
  • 62 Butler K, Teng R. Pharmacokinetics, pharmacodynamics, safety and tolerability of multiple ascending doses of ticagrelor in healthy volunteers. Br J Clin Pharmacol 2010; 70: 65-77
    CrossrefPubMedGoogle Scholar
  • 63 Savonitto S, D’Urbano M, Caracciolo M et al. Urgent surgery in patients with a recently implanted coronary drug-eluting stent: a phase II study of ‘bridging’ antiplatelet therapy with tirofiban during temporary withdrawal of clopidogrel. Br J Anaesth 2010; 104: 285-291
    CrossrefPubMedGoogle Scholar
  • 64 Angiolillo DJ, Firstenberg MS, Price MJ et al. Bridging antiplatelet therapy with cangrelor in patients undergoing cardiac surgery: a randomized controlled trial. JAMA 2012; 307: 265-274
    CrossrefPubMedGoogle Scholar