The Challenge of Hemorrhagic Shock Management During Low-Molecular-Weight Heparin Treatment

Abstract

The reversal of low-molecular-weight heparin (LMWH) and the management of bleeding patients on LMWH remain highly challenging. Even if LMWH is very extensively administered in the prophylaxis and treatment of venous thrombosis, specific antidotes are lacking, and reversal strategies have very weak grade of evidences on clinical effectiveness. We here describe a reversal strategy with protamine and FVIIa in a patient presenting with hemorrhagic shock and cardiocirculatory arrest.

Keywords:

• LMWH bleeding
• LMWH reversal
• FVIIa
• protamine
• mantle lymphoma

Ethical Disclosure

The case report was described upon written informed consent of the patient’s son and daughter to have the case details published. The patient passed away before publication for causes independent of the case report. Institutional approval was not required for publication.

Disclosure

The authors report no conflicts of interest in this work.