ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (Live and Virtual) | May 2023-Practical Approach in the Management of Anticoagulation in the Setting of GI Bleeding

Practical Approach in the Management of Anticoagulation in the Setting of GI Bleeding

Video Transcription

Video Summary

The webinar discussed the practical approach in the management of anticoagulation in the setting of GI bleeding. The speakers emphasized the importance of accurately defining a life-threatening hemorrhage, which helps inform the management strategy. For patients on warfarin, it was recommended to consider prothrombin complex concentrate (PCC) administration in cases of life-threatening bleeding. Platelet transfusion was not recommended in patients on antiplatelet agents, as it was associated with an increased risk of mortality. The timing of holding antiplatelet agents and warfarin prior to elective endoscopic procedures was discussed. It was advised to hold dual antiplatelet therapy for 2 to 3 days prior to procedures, depending on the bleeding risk of the procedure. As for warfarin, it was recommended to continue it for low-risk procedures and hold it for 5 days for advanced procedures. The webinar also mentioned the importance of knowing the bleeding risk of specific endoscopic procedures in order to guide the management of anticoagulation. Overall, the speakers provided practical recommendations based on the latest evidence to guide the management of anticoagulation in the setting of GI bleeding.

Keywords

webinar

anticoagulation

GI bleeding

hemorrhage

warfarin

prothrombin complex concentrate

platelet transfusion

endoscopic procedures

bleeding risk