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Inchingolo F, Inchingolo AM, Piras F, Ferrante L, Mancini A, Palermo A, Inchingolo AD, Dipalma G. Management of Patients Receiving Anticoagulation Therapy in Dental Practice: A Systematic Review. Healthcare (Basel) 2024; 12:1537. [PMID: 39120240 PMCID: PMC11311453 DOI: 10.3390/healthcare12151537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Revised: 07/22/2024] [Accepted: 08/01/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND Anticoagulant drugs are a valuable tool for minimizing thrombotic risks in at-risk patients. The purpose of this study is to conduct a literature review highlighting the management of these drugs during daily clinical dental practice. MATERIALS AND METHODS We limited our search to English-language papers published between 1 January 1989, and 7 March 2024, in PubMed, Scopus and Web of Science that were relevant to our topic. In the search approach, the Boolean keywords "anticoagulant AND dentistry" were used. RESULTS Twenty-five clinical trials were included for final review from 623 articles obtained from the databases Web of Science (83), PubMed (382), and Scopus (158), eliminating duplicates and 79 off-topic items, resulting in 419 articles after removing 315 entries and confirming eligibility. Overall, these studies support the use of local hemostatic measures to manage the risk of bleeding in patients on anticoagulant therapy undergoing dental procedures and highlight the importance of greater education and collaboration among healthcare professionals. CONCLUSIONS Research and clinical investigation have improved understanding and management of dental procedures in patients undergoing anticoagulant or antiplatelet therapy. Hemostatic agents, clinical protocols, risk factors, and continuous education are essential for navigating the complexities of anticoagulant therapy, ensuring optimal outcomes and enhancing patient well-being.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
| | - Fabio Piras
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy or (A.M.I.); or (L.F.); or (A.M.); or (A.D.I.); or (G.D.)
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Kobata H, Sugie A, Kawakami M, Tanaka S, Sarapuddin G, Tucker A. Treatment strategies for patients with out-of-hospital cardiac arrest associated with traumatic brain injury: A case series. Am J Emerg Med 2024; 82:8-14. [PMID: 38749373 DOI: 10.1016/j.ajem.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 04/04/2024] [Accepted: 05/06/2024] [Indexed: 07/19/2024] Open
Abstract
INTRODUCTION Collapse after out-of-hospital cardiac arrest (OHCA) can cause severe traumatic brain injury (TBI). We aimed to investigate the clinical characteristics and treatment strategies for patients with OHCA and TBI. METHODS We analyzed a consecutive cohort of patients with intrinsic OHCA retrospectively treated between January 2011 and December 2021 at a single critical care center, and presented a case series of seven patients. Patients with collapse-related TBI were examined for the causes and situations of cardiac arrest, laboratory data, radiological images, targeted temperature management (TTM), coronary angiography (CAG), percutaneous coronary intervention (PCI), and extracorporeal cardiopulmonary resuscitation (ECPR). RESULTS Of the 197 patients with intrinsic OHCA, 7 (3.6%) had TBI (age range: 49-70Â years; 6 men). All seven patients presented with ventricular fibrillation in the initial electrocardiograms, with four refractory cases treated with ECPR. All patients underwent CAG under heparinization, and four underwent PCI with antiplatelet administration. Initial head computed tomography indicated an intracranial hemorrhage (ICH) in three patients. ICH appeared or was exacerbated in six patients after CAG with or without PCI, except in one who underwent delayed PCI. All patients displayed elevated plasma D-dimer levels, and four underwent neurosurgical procedures. Four patients survived (three with cerebral performance category [CPC] 2, one with CPC 3) and three died; two had hypoxic-ischemic brain injury and one had severe TBI. CONCLUSION Delayed ICH occurred frequently. Individualized management is required based on the extent of brain and cardiac damage, including optimal TTM, PCI procedures, and antiplatelet medications. Early detection of ICH and emergency treatment are critical for multi-disciplinary collaboration.
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Affiliation(s)
- Hitoshi Kobata
- Osaka Mishima Emergency Critical Center, 11-1 Minami-akutagawacho, Takatsuki, Osaka 569-1124, Japan; Department of Neurosurgery, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan; Deparment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan.
| | - Akira Sugie
- Osaka Mishima Emergency Critical Center, 11-1 Minami-akutagawacho, Takatsuki, Osaka 569-1124, Japan; Emergency Medical Center, Ijinkai Takeda General Hospital, 28-1 Isidamoriminamicho, Fushimiku, Kyoto, 601-1495, Japan.
| | - Makiko Kawakami
- Osaka Mishima Emergency Critical Center, 11-1 Minami-akutagawacho, Takatsuki, Osaka 569-1124, Japan; Department of Anesthesiology, Osaka Saiseikai Suita Hospital, 1-2 Kawazonocho, Suita, Suita, Osaka 564-0013, Japan.
| | - Suguru Tanaka
- Osaka Mishima Emergency Critical Center, 11-1 Minami-akutagawacho, Takatsuki, Osaka 569-1124, Japan; Deparment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan.
| | - Gemmalynn Sarapuddin
- Osaka Mishima Emergency Critical Center, 11-1 Minami-akutagawacho, Takatsuki, Osaka 569-1124, Japan; Neurology Department, Institute of Neurosciences, The Medical City, Ortigas Avenue, Pasig, Metro Manila, Philippines.
| | - Adam Tucker
- Osaka Mishima Emergency Critical Center, 11-1 Minami-akutagawacho, Takatsuki, Osaka 569-1124, Japan; Department of Neurosurgery, Japanese Red Cross Kitami Hospital, 2-1 Kita 6-jo, higashi, Kitami, Hokkaido 090-8666, Japan.
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van 't Hof AWJ, Delnoij TSR, van der Horst ICC. Decision making in out-of-hospital cardiac arrest: what should come first? Neth Heart J 2024; 32:116-117. [PMID: 38324160 PMCID: PMC10884371 DOI: 10.1007/s12471-024-01856-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/08/2024] Open
Affiliation(s)
- Arnoud W J van 't Hof
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
- Department of Cardiology, Zuyderland Medical Centre, Heerlen, The Netherlands.
- Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
| | - Thijs S R Delnoij
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Iwan C C van der Horst
- Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, The Netherlands
- Department of Intensive Care, Maastricht University Medical Centre, Maastricht, The Netherlands
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