Author:
Mikael Häggström [notes 1]
Coagulation: Moderate risk of bleeding
This procedure counts as conferring a moderate risk of clinically significant bleeding.[1]
Required lab test
Prothrombin time (PT or INR):
- Inpatients: within 24 hours
- Outpatients with a healthy liver: Within 2 weeks
- Outpatients with liver disease and no additional acute disease since then: Within 1 week
Lab interpretation
- INR should be corrected if over 1.5
- If partial thromboplastin time (aPTT or APTT) has been taken, it should be corrected if over 1.5 times its normal upper limit.
- If platelet count has been performed, transfusion is indicated if it is below 50 x 109/L (equals 50,000/µL).
Anticoagulant medication
- Coumarin (warfarin): Normally stop 3-5 days before, in order to reach INR ≤ 1.5
- Low-molecular-weight heparin (LMWH): Stop 1 preceding dose
- Dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa, Lixiana):
- Glomerular filtration rate over 30 ml/min: Stop 2 days (48 hours) before
- Glomerular filtration rate less than 30 ml/min: Stop 3 days (72 hours) before
- Clopidogrel (Plavix), prasugrel (Efient), ticagrelor (Brilinta, Brilique, and Possia): Stop 5 days before
- Dipyridamole (Persantine): Stop 2 days (48 hours) before
- NSAIDs (including aspirin): No need to stop
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Example procedures
- Biopsy / drainage in the abdomen including liver biopsy and gallbladder drainage (not ascites drainage)
- Biopsy / drainage in the thorax including lung biopsy (not pleural drainage)
See also
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
