Abstract
Dabigatran is a novel oral direct thrombin inhibitor, licensed for stroke prevention in atrial fibrillation and the primary prevention of venous thromboembolism in patients who have undergone hip or knee replacement. It has been shown to cause a lower rate of major life-threatening haemorrhage compared to warfarin, although the incidence of gastrointestinal bleeding is higher. When bleeds do occur, however, there is no immediate reversal agent available. In several case reports, haemodialysis has been successfully used to treat life-threatening bleeding associated with dabigatran. We present a case of a patient receiving dabigatran who suffered a severe gastrointestinal bleed where haemodiafiltration did not provide rapid normalisation of clotting parameters as previously reported.