علاج النزيف الدماغي التلقائي داخل المخ في المرضى الذين يتلقون مضادات التخثر بالهيبارين

References

• In patients with anticoagulant-associated spontaneous ICH, anticoagulation should be discontinued immediately and rapid reversal of anticoagulation should be performed as soon as possible after diagnosis of spontaneous ICH to improve survival.
• In patients with unfractionated heparin (UFH)–associated spontaneous ICH, intravenous protamine is reasonable to reverse the anticoagulant effect of heparin.
• In patients with low-molecular-weight heparin (LMWH)–associated spontaneous ICH, intravenous protamine may be considered to partially reverse the anticoagulant effect of heparin.
• Intravenous protamine should not exceed 50 mg/10 min because of the risk of hypotension and bronchoconstriction; repeated smaller doses are preferable.

DOI: 10.1161/STR.0000000000000407