Open AccessSafe chest tube placement in a patient with tension pneumothorax receiving rivaroxaban therapy for non-valvular atrial fibrillation
Author(s) -
Alessandro Cipriano,
M Parollo,
Ester Taurino,
Elena Venturi,
Massimo Santini
Publication year - 2020
Publication title -
monaldi archives for chest disease. pulmonary series/monaldi archives for chest disease/monaldi archives for chest disease. cardiac series
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.196
H-Index - 46
eISSN - 2465-101X
pISSN - 1122-0643
DOI - 10.4081/monaldi.2020.1262
Subject(s) - medicine , rivaroxaban , thoracostomy , dabigatran , atrial fibrillation , pneumothorax , chest tube , surgery , warfarin , anesthesia , anticoagulant , tension pneumothorax , oral anticoagulant , cardiology
The number of patients treated with direct oral anticoagulants is increasing worldwide. Although bleeding complications associated with direct oral anticoagulants are lower than those associated with vitamin K antagonists, the increased number of patients treated with these anticoagulants suggests that a higher absolute number of patients are at risk. Tube thoracostomy is an invasive procedure with a high risk of bleeding. To date, among direct oral anticoagulants, only dabigatran has a well-studied antidote to reverse its effects during emergency procedure or surgery. This report describes a case in which emergency placement of a tube thoracostomy, in a patient with type 2 respiratory failure due to left tension pneumothorax and receiving the anticoagulant rivaroxaban, in the pharmacokinetics phase with greater anticoagulant effect, did not result in bleeding greater than that typically encountered during such interventions. The procedure ended successfully with no acute complications.