natlarkap
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Posts:10
Can a NSCLC hospitalized patient after Pericardiocentesis to drain effusion and Pericardial Window placement, be given blood thinners for clots? Is one blood thinner safer than another?
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Reply # - September 15, 2014, 02:01 PM
I'm afraid that's too
I'm afraid that's too specific a question to answer without being part of the team of doctors caring for the patient. There are discussions about blood thinners on the site that may be able to shed light on what thinners may be safer than others. However I'll ask Dr. Pennell to comment because there's often room for my misunderstandings. :wink:
This is a link to the 2 results pertaining to blood thinners and Pericardiocentesis http://cancergrace.org/search-results?q=bood%20thinners%20Pericardiocen…
I hope the person in question gets through this and does well for a good time.
Janine
Reply # - September 15, 2014, 02:25 PM
Hi natlarkap, thanks for
Hi natlarkap, thanks for posting. By and large, blood thinners (anticoagulation) can often be safely used after procedures and surgeries like pericardiocentesis or pericardial window if the doctors feels that the risk of bleeding is low enough, usually after enough time has passed for some healing to have taken place. This is not always easy to predict and can only be decided by the team of doctors caring for the patient. Sometimes if there is ongoing bleeding or the risk seems high, the doctor and patient must have a discussion about possible risks and decide either to try blood thinners despite the risk, or to decide the risk of clotting is lower than that of bleeding and put off starting blood thinners either temporarily or permanently.
As for choice of blood thinners, the medication that has the best evidence of preventing blood clots in lung cancer patients is low molecular weight heparin (LMWH), of which there are multiple brands. There are both advantages and disadvantages to this and all blood thinners (for example, it is not possible to completely stop the thinning of the blood with LMWH if dangerous bleeding starts). In the hospital and for high risk patients, doctors will sometimes use an intravenous medication called "unfractionated heparin" or just heparin, which acts quickly and can be shut off and/or reversed quickly if needed. There are multiple other choices for blood thinners, all with advantages and disadvantages that need to be personalized to the individual patient situation.
Reply # - September 15, 2014, 03:04 PM
Thank you both for your
Thank you both for your responses. I might have left out an important point. What I meant was can blood thinners be administered right after those procedures while still in the controlled environment of the hospital and be safely monitored to prevent excessive bleeding? Therefore, letting the thinners clear any present clots and prevent new ones since they also have a Lupus Anticoagulant Disorder (blood clotting disorder). Wouldn't the pericardial window prevent excessive bleeding to occur around the heart (I thought that was the purpose)? Also, the patient had an IVC placed during the periocardiocentesis. In that case, couldn't the "unfractionated heparin" be used safely and effectively?
Reply # - September 15, 2014, 08:19 PM
The purpose of the
The purpose of the pericardial window is to prevent excess fluid from building up in the pericardium, where it can put enough pressure on the heart that it affects the proper functioning of the heart (tamponade). In both procedures (placing the pericardial window and pericardiocentesis) tissue is cut, with the attendant risk of bleeding. If the blood has been thinned too much soon after the procedure (before the tissue has had an opportunity to heal), then uncontrolled bleeding can occur.
JimC
Forum moderator
Reply # - September 16, 2014, 03:32 AM
While I cannot comment on
While I cannot comment on your specific situation, heparin is often used for patients in the hospital who are at risk of bleeding so that it can be turned off quickly if bleeding starts. However, sometimes it is simply too risky to do any anticoagulation and a filter can help reduce the risk of a life-threatening clot while blood thinners are stopped.