Safe chest tube placement in a patient with tension pneumothorax receiving rivaroxaban therapy for non-valvular atrial fibrillation

Submitted: March 1, 2020
Accepted: May 4, 2020
Published: June 12, 2020
Abstract Views: 790
PDF: 477
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The number of patients treated with direct oral anticoagulants is increasing worldwide. Although bleeding complications associated with direct oral anticoagulants are lower than those associated with vitamin K antagonists, the increased number of patients treated with these anticoagulants suggests that a higher absolute number of patients are at risk. Tube thoracostomy is an invasive procedure with a high risk of bleeding. To date, among direct oral anticoagulants, only dabigatran has a well-studied antidote to reverse its effects during emergency procedure or surgery. This report describes a case in which emergency placement of a tube thoracostomy, in a patient with type 2 respiratory failure due to left tension pneumothorax and receiving the anticoagulant rivaroxaban, in the pharmacokinetics phase with greater anticoagulant effect, did not result in bleeding greater than that typically encountered during such interventions. The procedure ended successfully with no acute complications.

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Cipriano, Alessandro, Matteo Parollo, Ester Taurino, Elena Venturi, and Massimo Santini. 2020. “Safe Chest Tube Placement in a Patient With Tension Pneumothorax Receiving Rivaroxaban Therapy for Non-Valvular Atrial Fibrillation”. Monaldi Archives for Chest Disease 90 (2). https://doi.org/10.4081/monaldi.2020.1262.