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Newer Blood Thinner May Pose Danger to Trauma Patients
Date:11/23/2011

By Amanda Gardner
HealthDay Reporter

WEDNESDAY, Nov. 23 (HealthDay News) -- A new blood thinner touted for its convenience and enhanced quality of life may have hidden problems that could threaten the lives of certain patients, a new report suggests.

A letter to the editor in the Nov. 24 issue of the New England Journal of Medicine reports severe bleeding complications among trauma patients on the anti-clotting medicine Pradaxa (dabigatran etexilate).

In one case, a patient died, the letter said.

"We have noted on multiple occasions patients who have 'bleeding out' from Pradaxa and our hands are tied," said Dr. Bryan Cotton, lead letter author and a trauma surgeon with the University of Texas Health Science Center at Memorial Hermann Hospital in Houston. "They're bleeding out all over and there's absolutely nothing we can do about it . . . I'm helpless and hopeless when it comes into my emergency room."

The main problem, Cotton said, is that there's no real way to reverse the anti-clotting effect of the drug, unlike older agents such as warfarin.

According to the letter, the only way to reverse Pradaxa is with emergency dialysis but, said Cotton, "in a patient bleeding to death, that's not really a practical or pragmatic option."

Warfarin (Coumadin, Jantoven) has been the mainstay of blood-thinning medications to manage heart and stroke patients for decades.

But the drug is notoriously difficult to manage, requiring frequent lab tests and having interactions with multiple foods and other medications. Its one big advantage, however, is that its blood-thinning properties are easily reversible when needed.

Enter the new, easier-to-use blood thinner, Pradaxa, first approved by the U.S. Food and Drug Administration in late 2010 for use in patients with atrial fibrillation, a common and dangerous form of irregular heartbeat.

"There is an advantage over warfarin in ma
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