Skip to main content

Posts

Showing posts from August, 2018

Warfarin Management

Perioperative Warfarin (Coumadin) Management   Navigating a fine line between bleeding and thromboembolic complications Perioperative management of the chronically anticoagulated patient is like navigating a fine line between bleeding versus thromboembolic complications. INR The  INR  is used for monitoring patients who have been stabilized on Anticoagulant Therapy. Conventional Anticoagulation: INR = 2.0 - 3.0 High Intensity Anticoagulation: INR = 3.0 - 3.5 Any INR >5.0 is considered a CRITICAL "Bridging” is a term used to describe the temporary use of short-acting anticoagulants (heparin or Low Molecular Weight Heparin, LMWH) during the pause of warfarin therapy. LMWH available in the US:  dalteparin (Fragmin®) and enoxaparin (Lovenox®). CHAD SCORE C Congestive Heart failure 1 H Hypertension 1 A Age >75 years 1 D Diabetes 1 S2 Stroke or ...