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Case Reports in Critical Care
Volume 2015, Article ID 137504, 3 pages
http://dx.doi.org/10.1155/2015/137504
Case Report

Normalization of Activated Partial Thromboplastin Time Correlates with Low Levels of Dabigatran in a Patient with Severe Sepsis

Department of Anesthesia and Intensive Care, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, Denmark

Received 27 March 2015; Revised 7 June 2015; Accepted 22 June 2015

Academic Editor: Martin Albert

Copyright © 2015 Rikke Ebenhard Højland et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The oral anticoagulant dabigatran etexilate can be a challenge when patients need acute surgery. Sepsis and acute renal failure exacerbate the anticoagulant effect. There is no specific reversal agent for dabigatran etexilate, but it can be removed by hemodialysis. We present a case where a patient treated with dabigatran etexilate was admitted to intensive care unit with severe sepsis and acute renal failure and in need of bilateral lower limp amputation due to ischemia. The patient had severe coagulopathy and was treated with continuous venovenous hemofiltration in attempt to remove dabigatran etexilate before surgery.