Management of bleeding and emergency invasive procedures in patients on dabigatran: Updated guidelines from the French Working Group on Perioperative Haemostasis (GIHP) - September 2016

Anaesth Crit Care Pain Med. 2018 Aug;37(4):391-399. doi: 10.1016/j.accpm.2018.04.009. Epub 2018 May 2.


In 2013, the GIHP published guidelines for the management of severe haemorrhages and emergency surgery. This update applies to patients treated with dabigatran, with a bleeding complication or undergoing an urgent invasive procedure. It includes how to handle the available specific antidote (idarucizumab), when to measure dabigatran plasmatic concentration and when to use non-specific measures in these situations. It also includes guidelines on how to perform regional anaesthesia and analgesia procedures.

Keywords: Antidote; Bleeding; Dabigatran; Dabigatran concentration; Emergency; Surgery.

Publication types

  • Guideline
  • Review

MeSH terms

  • Antithrombins / adverse effects*
  • Antithrombins / therapeutic use
  • Dabigatran / adverse effects*
  • Dabigatran / therapeutic use
  • Emergency Medical Services / methods*
  • Hemostasis, Surgical / methods*
  • Humans
  • Perioperative Care / methods*
  • Surgical Procedures, Operative / methods*


  • Antithrombins
  • Dabigatran