An interesting mini-letter from my institution regarding dabigatran, thromboelastography, and poor outcomes.
It simply notes and reinforces the fact that conventional coagulation studies in patients on dabigatran will be normal – and therefore conventional reversal options are unlikely to be of value. The only abnormality detected was prolongation of the activated clotting time, corresponding to inhibition of enzymatic clotting.
Multiple patients have presented after traumatic injury to our institution, and they have universally had poor outcomes.
“Acutely Injured Patients on Dabigatran”
http://www.nejm.org/doi/full/10.1056/NEJMc1111095