Suggested cutoff values for several parameters and time interval for the interruption of different drugs prior to the most commonly performed procedures during flexible bronchoscopy

ProcedureResume therapy after
Patient-related risk factors and contraindications
 Pulmonary hypertensionNoNosPAP >50 mmHg or mPAP >30 mmHg
 Vena cava syndromeNoRelative contraindication
Haemostasis-related risk factors and contraindications
 Platelets ×109 per L<20 000<75 000
 INR/PTNo>1.4 or <60%
  UFH prophylactic doseNo6-h interval periodSame day
  UFH therapeutic doseNo6-h interval period4–12 h
  LWMH prophylactic doseNo10–12-h interval periodSame day
  LWMH therapeutic dose#No24-h interval period4–12 h
  FondaparinuxNo36–42-h interval period4–12 h
 Platelet-aggregation inhibitors
  Acetylsalicylic acidNoDo not stopNot stopped
  ClopidogrelNo5–7 days4–12 h
  TicagrelorNo5 days4–12 h
  PrasugrelNo7–10 days4–12 h
 Oral anticoagulants
  4-hydroxycoumarinNo5 days4–12 h
  AcenocoumarolNo3 days4–12 h
  PhenprocoumoneNo8 days4–12 h
 Oral anticoagulants+
  Dabigatran§No3 days4–12 h
  RivaroxabanNo2 days4–12 h
  Apixaban§No2 days4–12 h

BAL: bronchoalveolar lavage; EBB: endobronchial biopsy; TBNA: transbronchial needle aspiration; EBUS: endobronchial ultrasound; TBLB: transbronchial lung biopsy; INR: international normalised ratio; PT: prothrombin time; UFH: unfractionated heparin; LMWH: low molecular weight heparin; sPAP: systolic pulmonary arterial pressure; mPAP: mean pulmonary arterial pressure. #: normal renal function; : coumadine; +: direct thrombin inhibitor and direct factor Xa inhibitor; §: creatinine clearance >30 mL·min−1.