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Haematological factors in the management of adult epistaxis: systematic review.

Abstract The management of epistaxis requires an understanding of haematological factors that may complicate its treatment. This systematic review includes six distinct reviews examining the evidence supporting epistaxis-specific management strategies relating to warfarin, direct oral anticoagulants, heparin, antiplatelet agents, tranexamic acid and transfusion.
PMID
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Authors

Mayor MeshTerms
Keywords

Blood

Coumarins

Epistaxis

Heparin

Therapy

Journal Title the journal of laryngology and otology
Publication Year Start




PMID- 29280698
OWN - NLM
STAT- MEDLINE
DCOM- 20180102
LR  - 20180102
IS  - 1748-5460 (Electronic)
IS  - 0022-2151 (Linking)
VI  - 131
IP  - 12
DP  - 2017 Dec
TI  - Haematological factors in the management of adult epistaxis: systematic review.
PG  - 1093-1107
LID - 10.1017/S0022215117002067 [doi]
AB  - BACKGROUND: The management of epistaxis requires an understanding of
      haematological factors that may complicate its treatment. This systematic review 
      includes six distinct reviews examining the evidence supporting
      epistaxis-specific management strategies relating to warfarin, direct oral
      anticoagulants, heparin, antiplatelet agents, tranexamic acid and transfusion.
      METHOD: A systematic review of the literature was performed using a standardised 
      methodology and search strategy. RESULTS: Limited numbers of articles were
      identified in each systematic review, with level 1 evidence only regarding the
      use of tranexamic acid. No studies met the inclusion criteria within the heparin,
      direct oral anticoagulants or transfusion systematic reviews. Many studies were
      limited by small sample sizes and significant risk of bias. CONCLUSION: The
      management of major bleeding and transfusion practice is well documented in
      national guidance from multiple sources. The guidelines include advice on
      anticoagulants, antiplatelet agents and tranexamic acid. In the absence of more
      specific evidence, these guidelines should be applied in the management of
      epistaxis.
FAU - Williams, A
AU  - Williams A
AD  - Department of Anaesthesia,Derriford Hospital,Plymouth,UK.
FAU - Biffen, A
AU  - Biffen A
AD  - Department of Anaesthesia,Derriford Hospital,Plymouth,UK.
FAU - Pilkington, N
AU  - Pilkington N
AD  - Department of Anaesthesia,Derriford Hospital,Plymouth,UK.
FAU - Arrick, L
AU  - Arrick L
AD  - Department of Anaesthesia,Derriford Hospital,Plymouth,UK.
FAU - Williams, R J
AU  - Williams RJ
AD  - Institute of Naval Medicine,Gosport,UK.
FAU - Smith, M E
AU  - Smith ME
AD  - Department of Otolaryngology,Addenbrooke's Hospital,Cambridge,UK.
FAU - Smith, M
AU  - Smith M
AD  - Exeter Health Library,Peninsula Medical School,UK.
FAU - Birchall, J
AU  - Birchall J
AD  - Department of Haematology,North Bristol NHS Trust,NHS Blood and
      Transplant,Bristol,UK.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - J Laryngol Otol
JT  - The Journal of laryngology and otology
JID - 8706896
RN  - 0 (Anticoagulants)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 5Q7ZVV76EI (Warfarin)
RN  - 6T84R30KC1 (Tranexamic Acid)
RN  - 9005-49-6 (Heparin)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Anticoagulants/adverse effects/therapeutic use
MH  - Blood Transfusion
MH  - Epistaxis/*blood/chemically induced/*therapy
MH  - Evidence-Based Medicine
MH  - Guideline Adherence
MH  - Heparin/adverse effects/therapeutic use
MH  - Humans
MH  - International Normalized Ratio
MH  - Length of Stay
MH  - Platelet Aggregation Inhibitors/adverse effects/therapeutic use
MH  - Tranexamic Acid/adverse effects/therapeutic use
MH  - Treatment Outcome
MH  - Warfarin/adverse effects/therapeutic use
OTO - NOTNLM
OT  - Blood
OT  - Coumarins
OT  - Epistaxis
OT  - Heparin
OT  - Therapy
EDAT- 2017/12/28 06:00
MHDA- 2017/12/28 06:00
CRDT- 2017/12/28 06:00
PHST- 2017/12/28 06:00 [entrez]
PHST- 2017/12/28 06:00 [pubmed]
PHST- 2017/12/28 06:00 [medline]
AID - S0022215117002067 [pii]
AID - 10.1017/S0022215117002067 [doi]
PST - ppublish
SO  - J Laryngol Otol. 2017 Dec;131(12):1093-1107. doi: 10.1017/S0022215117002067.