Markers Of Thromboembolic Risk Were Insignificantly Affected By Either Intraosseous Or Intravenous Idarucizumab In A Dabigatran-Anticoagulated Porcine Polytrauma Model

Introduction: Idarucizumab is a monoclonal humanized antibody fragment (Fab), designed to reverse dabigatran anticoagulation. It is approved for urgent reversal of dabigatran anticoagulant effects in massive bleeding or prior to urgent interventions. It is administered intravenously (i.v.), either as a bolus or a short infusion (2x2.5 g). In hemorrhagic shock gaining i.v. might be challenging, and alternative methods such as intraosseous (i.o.) administration are an alternative life-saving procedure. Due to the molecular size of idarucizumab (50 kDa), the efficacy and safety, including the passage from the i.o. compartment to circulation, are unknown. In this study we investigated the efficacy and the prothrombotic risk of idarucizumab, given i.v. and i.o. in a large animal polytrauma model.