PDF(Pubmed)
Abstract：
UNASSIGNED: In case of bleeding patients and in acute care, the assessment of residual direct oral anticoagulant (DOAC) activity is essential for evaluating the potential impact on hemostasis, especially when a timely decision on urgent surgery or intervention is required. Viscoelastic tests are crucial in a modern goal-directed coagulation management to assess patients\' coagulation status. However, the role of viscoelastic test to detect and quantify residual DOAC plasma levels is controversially discussed. The aim of this review was to systematically summarize the evidence of viscoelastic tests for the assessment of residual DOAC activity.
UNASSIGNED: PubMed, Embase, Scopus, and the Cochrane Library were searched for original articles investigating the effect of rivaroxaban, apixaban, edoxaban, or dabigatran plasma levels on different viscoelastic tests of the adult population from database inception to December 31, 2021.
UNASSIGNED: We included 53 studies from which 31 assessed rivaroxaban, 22 apixaban, six edoxaban, and 29 dabigatran. The performance of viscoelastic tests varied across DOACs and assays. DOAC specific assays are more sensitive than unspecific assays. The plasma concentration of rivaroxaban and dabigatran correlates strongly with the ROTEM EXTEM, ClotPro RVV-test or ECA-test clotting time (CT) and TEG 6s anti-factor Xa (AFXa) or direct thrombin inhibitor (DTI) channel reaction time (R). Results of clotting time (CT) and reaction time (R) within the normal range do not reliable exclude relevant residual DOAC plasma levels limiting the clinical utility of viscoelastic assays in this context.
UNASSIGNED: Viscoelastic test assays can provide fast and essential point-of-care information regarding DOAC activity, especially DOAC specific assays. The identification and quantification of residual DOAC plasma concentration with DOAC unspecific viscoelastic assays are not sensitive enough, compared to recommended anti-Xa activity laboratory measurements.
UNASSIGNED: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320629], identifier [CRD42022320629].
UNASSIGNED: PubMed, Embase, Scopus, and the Cochrane Library were searched for original articles investigating the effect of rivaroxaban, apixaban, edoxaban, or dabigatran plasma levels on different viscoelastic tests of the adult population from database inception to December 31, 2021.
UNASSIGNED: We included 53 studies from which 31 assessed rivaroxaban, 22 apixaban, six edoxaban, and 29 dabigatran. The performance of viscoelastic tests varied across DOACs and assays. DOAC specific assays are more sensitive than unspecific assays. The plasma concentration of rivaroxaban and dabigatran correlates strongly with the ROTEM EXTEM, ClotPro RVV-test or ECA-test clotting time (CT) and TEG 6s anti-factor Xa (AFXa) or direct thrombin inhibitor (DTI) channel reaction time (R). Results of clotting time (CT) and reaction time (R) within the normal range do not reliable exclude relevant residual DOAC plasma levels limiting the clinical utility of viscoelastic assays in this context.
UNASSIGNED: Viscoelastic test assays can provide fast and essential point-of-care information regarding DOAC activity, especially DOAC specific assays. The identification and quantification of residual DOAC plasma concentration with DOAC unspecific viscoelastic assays are not sensitive enough, compared to recommended anti-Xa activity laboratory measurements.
UNASSIGNED: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=320629], identifier [CRD42022320629].
摘要：
未经证实：在出血患者和急性护理中，残留直接口服抗凝剂（DOAC）活性的评估对于评估对止血的潜在影响至关重要，特别是当需要及时决定紧急手术或干预时。粘弹性测试对于评估患者凝血状态的现代目标指导凝血管理至关重要。然而,粘弹性试验在检测和量化残余DOAC血浆水平方面的作用存在争议。这篇综述的目的是系统地总结用于评估残留DOAC活性的粘弹性测试的证据。
未经授权：PubMed，Embase,Scopus,并在Cochrane图书馆搜索了研究利伐沙班影响的原始文章，阿哌沙班,edoxaban,从数据库开始到2021年12月31日，在成人人群的不同粘弹性测试中，或达比加群血浆水平。
未经评估：我们纳入了53项研究，其中31项评估了利伐沙班，22阿哌沙班，六个edoxaban,和29Dabigatran.粘弹性测试的性能因DOAC和测定而异。DOAC特异性测定比非特异性测定更灵敏。利伐沙班和达比加群的血浆浓度与ROTEMEXTEM密切相关，ClotProRVV测试或ECA测试凝血时间（CT）和TEG6s抗因子Xa（AFXa）或直接凝血酶抑制剂（DTI）通道反应时间（R）。正常范围内的凝血时间(CT)和反应时间(R)的结果不可靠地排除相关的残留DOAC血浆水平,从而限制粘弹性测定在这种情况下的临床应用。
UNASSIGNED：粘弹性测试测定可提供有关DOAC活性的快速和必要的即时信息，尤其是DOAC特异性测定。用DOAC非特异性粘弹性测定法鉴定和定量残余DOAC血浆浓度不够灵敏，与推荐的抗Xa活性实验室测量相比。
UNASSIGNED：[https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=320629],标识符[CRD42022320629]。
未经授权：PubMed，Embase,Scopus,并在Cochrane图书馆搜索了研究利伐沙班影响的原始文章，阿哌沙班,edoxaban,从数据库开始到2021年12月31日，在成人人群的不同粘弹性测试中，或达比加群血浆水平。
未经评估：我们纳入了53项研究，其中31项评估了利伐沙班，22阿哌沙班，六个edoxaban,和29Dabigatran.粘弹性测试的性能因DOAC和测定而异。DOAC特异性测定比非特异性测定更灵敏。利伐沙班和达比加群的血浆浓度与ROTEMEXTEM密切相关，ClotProRVV测试或ECA测试凝血时间（CT）和TEG6s抗因子Xa（AFXa）或直接凝血酶抑制剂（DTI）通道反应时间（R）。正常范围内的凝血时间(CT)和反应时间(R)的结果不可靠地排除相关的残留DOAC血浆水平,从而限制粘弹性测定在这种情况下的临床应用。
UNASSIGNED：粘弹性测试测定可提供有关DOAC活性的快速和必要的即时信息，尤其是DOAC特异性测定。用DOAC非特异性粘弹性测定法鉴定和定量残余DOAC血浆浓度不够灵敏，与推荐的抗Xa活性实验室测量相比。
UNASSIGNED：[https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=320629],标识符[CRD42022320629]。
