医学
抗血栓
凝血病
重症监护医学
血栓形成
败血症
弥漫性血管内凝血
内科学
作者
Bruna Gigante,Jerrold H. Levy,Eric C. M. Van Gorp,Alessandro Bartoloni,Marie‐Luce Bochaton‐Piallat,Magnus Bäck,Hugo Ten Cate,Christina Christersson,José Luis Ferreiro,Tobias Geisler,Esther Lutgens,Sam Schulman,Robert F. Storey,Jecko Thachil,Gemma Vilahur,Patricia C. Liaw,Bianca Rocca
标识
DOI:10.1093/eurheartj/ehad388
摘要
Abstract Patients with severe infections and a pre-existing indication for antithrombotic therapy, i.e. antiplatelet agents, anticoagulant drugs, or their combinations, require integrated clinical counselling among coagulation, infectious disease, and cardiology specialists, due to sepsis-induced coagulopathy that frequently occurs. Bacterial and viral pathogens constitute an increasing threat to global public health, especially for patients with ongoing antithrombotic treatment who have a high risk of thrombotic recurrences and high susceptibility to severe infections with increased morbidity and mortality. Similarly, sepsis survivors are at increased risk for major vascular events. Coagulopathy, which often complicates severe infections, is associated with a high mortality and obligates clinicians to adjust antithrombotic drug type and dosing to avoid bleeding while preventing thrombotic complications. This clinical consensus statement reviews the best available evidence to provide expert opinion and statements on the management of patients hospitalized for severe bacterial or viral infections with a pre-existing indication for antithrombotic therapy (single or combined), in whom sepsis-induced coagulopathy is often observed. Balancing the risk of thrombosis and bleeding in these patients and preventing infections with vaccines, if available, are crucial to prevent events or improve outcomes and prognosis.
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