Patients on Anticoagulants

There are varied reasons for a patient to be on anticoagulation including thromboembolism, venous or arterial thrombosis, prosthetic heart valve, etc. Patients admitted to the intensive care unit are on injectable heparin or low molecular weight heparin commonly. Patients on prior oral anticoagulants may present to the critical care setting with bleeding which may be life threatening. Coumarin derivatives were the common oral anticoagulants used. With the advent of novel oral anticoagulants (NOACs) which are being prescribed more commonly than before, patients do present with bleeding complications of the same. It is important to know and understand the mechanism of these NOACs. In this chapter, we cover the management of a bleeding patient on these NOACs.