![]() ![]() ![]() retroperitoneal, intra-articular, pericardial, epidural, or intracranial bleeding, or intramuscular bleeding with compartment syndrome) ![]() Bleeding in a critical area or organ (i.e.Bleeding associated with a decrease in hemoglobin level of at least 2g/dL (or a Hb ≤8g/dL if no baseline hemoglobin).severe hypotension, poor kin perfusion, confusion, or low cardiac output that could not otherwise be explained) Potentially life-threatening bleeding with signs or symptoms of hemodynamic compromise (i.e.Acute Major Bleeding = bleeding having one or more of the following features:.Patients enrolled at 63 centers in North America and Europe.Multicenter, prospective, open-label, single-group cohort study, assessing the biological efficacy and safety of andexanet in patients with acute major bleeding.Enoxaparin, Edoxaban, or Rivaroxaban ≤7hrs prior to Andexanet Alfa bolus or unknown time = 800mg over 30 minutes followed by 2hr infusion dose of 960mg.Apixaban or rivaroxaban >7hrs prior to Andexanet Alfa bolus = 400mg over at minutes and then a 2hr infusion dose of 480mg.Patients with acute major bleeding within 18 hours after administration of a factor Xa inhibitor were given a bolus of andexanet alpha followed by a 2-hour infusion.Andexanet Alfa, a Novel Antidote to the anticoagulation Effects of Factor Xa Inhibitors (ANNEXA-4).In May of 2018, Andexanet alfa gained accelerated approval by the FDA for the reversal of these agents, but robust evidence in its support have been lacking. ![]() These agents unfortunately do not have any specific reversal agents. Despite these advantages, the risk of bleeding remains a concern. The reason for this is the ease of use, standard dosing with no levels to check and no injections needed. Background: Over the past few years we have seen a surge in the use of oral Factor Xa inhibitors (apixaban, rivaroxaban etc) for anticoagulation. ![]()
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