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1. Gestion des agents antiplaquettaires en cas de procédure invasive non programmée ou d’hémorragie. Propositions du Groupe d’intérêt en hémostase périopératoire (GIHP) et du Groupe français d’études sur l’hémostase et la thrombose (GFHT) en collaboration avec la Société française d’anesthésie et de réanimation (SFAR)

Author

Normand Blais, François Mullier, Dan Longrois, Nathalie Nathan, Serge Motte, S. Laporte, Juan V. Llau, Yves Gruel, Stéphanie Roullet, J. Guay, J.-L. Bosson, Philippe Nguyen, P. van Der Linden, Dominique Lasne, Annick Steib, P.E. Morange, Anne Godier, Pierre Albaladejo, Sophie Susen, Brigitte Ickx, Jerrold H. Levy, G. Pernod, Emmanuel Marret, Samia Madi-Jebara, Guy Meyer, Yves Ozier, David Faraoni, Fanny Bonhomme, E. van Belle, Jean-François Schved, Mikael Mazighi, André Vincentelli, Patrick Mismetti, J.L. Mas, P.M. Roy, Emmanuel de Maistre, Jean-Philippe Collet, Sylvie Schlumberger, Y. Huet, Pierre Fontana, Charles Marc Samama, Delphine Garrigue, J.Y. Borg, Nadia Rosencher, S. Belisle, Jean-François Hardy, Thomas Lecompte, P. Sié, D. Garrigue Huet, P. Zufferey, A. Borel-Derlon, A. Cohen, S. Lessire, G. Le Gal, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service d'anesthésiologie, and UCL - (MGD) Laboratoire de biologie clinique

Subjects
03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, Agent antiplaquettaireChirurgieHémorragieThromboseAnesthésie locorégionale, 030202 anesthesiology, 030204 cardiovascular system & hematology
Abstract

Le Groupe d’intérêt en hémostase périopératoire (GIHP) et le Groupe français d’études sur l’hémostase et la thrombose (GFHT), en collaboration avec la Société française d’anesthésie et de réanimation (SFAR) ont fait des propositions de gestion des agents antiplaquettaires (AAP) pour une procédure invasive programmée. Ces propositions ont été discutées et validées par vote ; toutes sauf une ont fait l’objet d’un accord fort. La gestion des AAP dépend de leur indication et de la procédure considérée. Le risque hémorragique lié à la procédure invasive peut être divisé en bas, intermédiaire ou élevé, selon la possibilité ou non de réaliser la procédure sous traitement (sous respectivement bithérapie antiplaquettaire, aspirine en monothérapie ou aucun AAP). Si une interruption des AAP est indiquée avant la procédure, une dernière prise d’aspirine, clopidogrel, ticagrélor et prasugrel 3, 5, 5 et 7 jours avant la procédure est proposée. Le risque thrombotique associé à l’interruption des AAP doit être évalué en fonction de l’indication des AAP. Il est plus élevé chez les patients traités par bithérapie pour un stent coronaire que chez ceux traités par monothérapie pour une prévention cardiovasculaire, un antécédent d’accident vasculaire cérébral ischémique ou une artériopathie oblitérante des membres inférieurs. Ces propositions concernent aussi le rôle potentiel des tests fonctionnels plaquettaires, la gestion des AAP pour l’anesthésie locorégionale, centrale et périphérique, et pour la chirurgie cardiaque coronaire.

Published
2019
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2. Diagnosis and management of heparin-induced thrombocytopenia

Author

Yves Ozier, F. Mullier, P. Albaladejo, Grégoire Le Gal, Jean-François Schved, Sophie Susen, Jean-Philippe Collet, Emmanuel Marret, Yves Gruel, Jean-François Hardy, Claire Pouplard, N. Blais, D. Lasne, Sylvie Schlumberger, Thomas Lecompte, A. Vincentelli, J.Y. Borg, Brigitte Ickx, A. Godier, Guy Meyer, E de Maistre, Dan Longrois, Samia Madi-Jebara, Sophie Testa, Nathalie Nathan, Mikael Mazighi, André Vincentelli, Joanne Guay, S. Laporte, P.M. Roy, Emmanuel de Maistre, D. Garrigue Huet, P. Zufferey, Y. Huet, Nadia Rosencher, P. Van der Linden, Dominique Lasne, S. Roullet, Y. Gruel, François Mullier, P. Sié, Philippe Nguyen, David Faraoni, Normand Blais, Jerrold H. Levy, Annick Steib, P.E. Morange, S. Lessire, G. Le Gal, Juan V. Llau, Anne Godier, Sylvain Bélisle, Pierre Albaladejo, Serge Motte, Stéphanie Roullet, J.-L. Bosson, Patrick Mismetti, Fanny Bonhomme, Charles-Marc Samama, E. van Belle, J.L. Mas, Pierre Fontana, G. Pernod, S. Susen, A. Borel-Derlon, A. Cohen, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service d'anesthésiologie, UCL - (MGD) Laboratoire de biologie clinique, Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Clinique, business.industry, MEDLINE, General Medicine, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, medicine.disease, Gastroenterology, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030220 oncology & carcinogenesis, Heparin-induced thrombocytopenia, Internal medicine, medicine, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Heparin-induced thrombocytopenia (HIT) is a rare, iatrogenic disease characterised by its potential severity, mainly related to thrombosis, and by difficulties regarding its diagnosis and management of affected patients. In 2002, a conference of experts mobilised by the French Society of Anaesthesia and Intensive Care Medicine (Société française d’anesthésie et de réanimation [SFAR]) drafted recommendations for the management of HIT [...]

Published
2020
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3. Management of antiplatelet therapy in patients undergoing elective invasive procedures: Proposals from the French Working Group on perioperative hemostasis (GIHP) and the French Study Group on thrombosis and hemostasis (GFHT

Author

Anne Godier, Pierre Fontana, Serge Motte, Annick Steib, Fanny Bonhomme, Sylvie Schlumberger, Thomas Lecompte, Nadia Rosencher, Sophie Susen, André Vincentelli, Yves Gruel, Pierre Albaladejo, Jean-Philippe Collet, P. Albaladejo, S. Belisle, N. Blais, F. Bonhomme, A. Borel-Derlon, J.Y. Borg, J.-L. Bosson, A. Cohen, J.-P. Collet, E. de Maistre, D. Faraoni, P. Fontana, D. Garrigue Huet, A. Godier, Y. Gruel, J. Guay, J.F. Hardy, Y. Huet, B. Ickx, S. Laporte, D. Lasne, J.H. Levy, J. Llau, G. Le Gal, T. Lecompte, S. Lessire, D. Longrois, S. Madi-Jebara, E. Marret, J.L. Mas, M. Mazighi, P. Mismetti, P.E. Morange, S. Motte, F. Mullier, N. Nathan, P. Nguyen, Y. Ozier, G. Pernod, N. Rosencher, S. Roullet, P.M. Roy, C.M. Samama, S. Schlumberger, J.F. Schved, P. Sié, A. Steib, S. Susen, E. van Belle, P. van Der Linden, A. Vincentelli, P. Zufferey, Fondation Ophtalmologique Adolphe de Rothschild [Paris], Université de Genève (UNIGE), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Techniques pour l'Evaluation et la Modélisation des Actions de la Santé (TIMC-IMAG-ThEMAS), Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Département d'hématologie biologique[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, and French Working Group On Perioperative Hemostasis (gihp)

Subjects
Local anaesthesia, medicine.medical_specialty, Consensus, [SDV]Life Sciences [q-bio], Treatment outcome, Blood Loss, Surgical, 030204 cardiovascular system & hematology, Postoperative Hemorrhage, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Hémorragie, Risk Factors, Intensive care, Surgical, Medicine, Humans, In patient, Blood Loss, Chirurgie, ComputingMilieux_MISCELLANEOUS, Agent antiplaquettaire, ddc:616, Hemostasis, ddc:617, business.industry, General surgery, Antiplatelet therapy, Thrombosis, General Medicine, Perioperative, medicine.disease, 3. Good health, Treatment Outcome, Thrombose, Anesthésie loco-régionale, Haemorrhage, Elective Surgical Procedures, Platelet aggregation inhibitor, Surgery, France, Cardiology and Cardiovascular Medicine, business, Elective Surgical Procedure, 030217 neurology & neurosurgery, Platelet Aggregation Inhibitors
Abstract

International audience

Published
2018
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4. Management of antiplatelet therapy in patients undergoing elective invasive procedures. Proposals from the French Working Group on perioperative haemostasis (GIHP) and the French Study Group on thrombosis and haemostasis (GFHT). In collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR)

Author

Anne Godier, Pierre Fontana, Serge Motte, Annick Steib, Fanny Bonhomme, Sylvie Schlumberger, Thomas Lecompte, Nadia Rosencher, Sophie Susen, André Vincentelli, Yves Gruel, Pierre Albaladejo, Jean-Philippe Collet, P. Albaladejo, S. Belisle, N. Blais, F. Bonhomme, A. Borel-Derlon, J.Y. Borg, J.-L. Bosson, A. Cohen, J.-P. Collet, E. de Maistre, D. Faraoni, P. Fontana, D. Garrigue Huet, A. Godier, Y. Gruel, J. Guay, J.F. Hardy, Y. Huet, B. Ickx, S. Laporte, D. Lasne, J.H. Levy, J. Llau, G. Le Gal, T. Lecompte, S. Lessire, D. Longrois, S. Madi-Jebara, E. Marret, J.L. Mas, M. Mazighi, P. Mismetti, P.E. Morange, S. Motte, F. Mullier, N. Nathan, P. Nguyen, Y. Ozier, G. Pernod, N. Rosencher, S. Roullet, P.M. Roy, C.M. Samama, S. Schlumberger, J.F. Schved, P. Sié, A. Steib, S. Susen, E. van Belle, P. van Der Linden, A. Vincentelli, P. Zufferey, UCL - (MGD) Service d'anesthésiologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, and UCL - (MGD) Laboratoire de biologie clinique

Subjects
medicine.medical_specialty, Prasugrel, Blood Loss, Surgical, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, Perioperative Care, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Aspirin, business.industry, Bleeding, Antiplatelet agents, Généralités, Thrombosis, General Medicine, Perioperative, medicine.disease, Clopidogrel, Hemostasis, Surgical, Discontinuation, Anesthesiology and Pain Medicine, Elective Surgical Procedures, Anesthesia, Surgery, business, Regional anaesthesia, Ticagrelor, Platelet Aggregation Inhibitors, medicine.drug
Abstract

The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR) drafted up-to-date proposals for the management of antiplatelet therapy in patients undergoing elective invasive procedures. The proposals were discussed and validated by a vote; all proposals but one could be assigned with a high strength. The management of antiplatelet therapy is based on their indication and the procedure. The risk of bleeding related to the procedure can be divided into high, moderate and low categories depending on the possibility of performing the procedure in patients receiving antiplatelet agents (none, monotherapy and dual antiplatelet therapy respectively). If discontinuation of antiplatelet therapy is indicated before the procedure, a last intake of aspirin, clopidogrel, ticagrelor and prasugrel 3, 5, 5 and 7 days before surgery respectively is proposed. The thrombotic risk associated with discontinuation should be assessed according to each specific indication of antiplatelet therapy and is higher for patients receiving dual therapy for coronary artery disease (with further refinements based on a few well-accepted items) than for those receiving monotherapy for cardiovascular prevention, for secondary stroke prevention or for lower extremity arterial disease. These proposals also address the issue of the potential role of platelet functional tests and consider management of antiplatelet therapy for regional anaesthesia, including central neuraxial anaesthesia and peripheral nerve blocks, and for coronary artery surgery., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2018

6. Anticoagulants circulants en dehors de l'hémophilie

Author

Du Lê Thi Houng, L. Guillevin, J.Y. Borg, J.F. Besancenot, G. Le Roux, F. Mallein, M.H. Aurousseau, M. Mahieu, Y. Le Tallec, J.L. Guilmot, J.L. Wiederkehr, D. Kleinknecht, B. Couret, J.G. Fuzibet, D. Vital Durand, H. Rousset, J.F. Schved, C. Thery, M.L. Wissel, and P. Cortet

Subjects
medicine.medical_specialty, Pediatrics, Pregnancy, Systemic lupus erythematosus, business.industry, medicine.drug_class, Anticoagulant, Gastroenterology, Cancer, Abortion, medicine.disease, Thrombosis, Internal medicine, Internal Medicine, Medicine, Circulating anticoagulants, business, Vasculitis
Abstract

A retrospective multicentre study, undertaken under the aegis of the French National Society of Internal Medicine, involved 200 subjects with acquired circulating anticoagulants; 130 were female and 77 were male; mean age was 45 +/- 23 years (range: 10 months to 80 years). Mean duration of follow-up was 23 months. In 130 subjects the anticoagulants were detected as a result of a systematic screening examination. The main overt clinical manifestations were haemorrhages, venous or arterial thrombosis and spontaneous abortion. Typing of the anticoagulant, performed in 166 cases, showed the presence of an antiprothrombinase in 141; this enzyme is not responsible for severe bleeding unless it is associated with other disorders of coagulation; less frequent were an anti-factor VIIIc (n = 16) and an anti-factor V (n = 2) anticoagulants. An underlying pathology was found in 172 subjects, including systemic lupus erythematosus (n = 60), induced lupus (n = 11), discoid lupus (n = 3), infection (n = 23), blood disease (n = 19), cancer (n = 15) and vasculitis (n = 15); other factors were pregnancy (n = 5) and medicines (n = 6). The anticoagulant disappeared spontaneously in 10 cases and in 33 of the 115 subjects treated. In subjects with lupus and in children under twelve years of age, an antiprothrombinase was regularly identified at typing.

Published
1988
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