Novel techniques in the use of bivalirudin for cardiopulmonary bypass anticoagulation in a child with heparin-induced thrombocytopenia

Dragomer, D; Chalfant, A; Biniwale, R; Reemtsen, B; Federman, M
November 2011
Perfusion;Nov2011, Vol. 26 Issue 6, p516
Academic Journal
Case Study
Heparin-induced thrombocytopenia (HIT) occurs in both the pediatric and adult populations after exposure to heparin. Bivalirudin has been used as an alternative to heparin for adults undergoing cardiac surgery and cardiopulmonary bypass, but has only been used minimally in children for this purpose. We report the successful use of bivalirudin for anticoagulation during cardiopulmonary bypass in a small child with HIT, using novel techniques not previously described.


Related Articles

  • Delayed thrombin generation is not associated with fibrinopeptide formation during prolonged cardiopulmonary bypass with hirudin anticoagulation. Belway, D.; Rubens, F. D.; Henley, B.; Babaev, A.; Mesana, T. // Perfusion;Sep2006, Vol. 21 Issue 5, p259 

    Patients with heparin-induced thrombocytopenia urgently requiring surgery with cardiopulmonary bypass (CPB) present a unique management challenge that must be addressed by the use of alternative anticoagulants. Although clinical success with the direct thrombin inhibitor hirudin has been...

  • Gabexate mesilate and antithrombin III for intraoperative anticoagulation in heparin pretreated patients. Ranucci, M.; Cazzaniga, A.; Isgrò, G.; Ditta, A.; Boncilli, A.; Cotza, M.; Brozzi, S. // Perfusion;1999, Vol. 14 Issue 5, p357 

    Thirty patients scheduled for elective myocardial revascularization and having undergone preoperative heparin treatment have been admitted to this prospective, randomized study. The aim of the study was to test two different strategies for preserving circulating antithrombin III (AT-III) during...

  • A Comparison of Heparin and New Anticoagulants for Cardiopulmonary Bypass Surgery. Belougne-Malfattie, Emmanuelle; Aguejouf, Omar; Labrousse, Louis; Doutremepuich, Christian // Clinical & Applied Thrombosis/Hemostasis;Apr1998, Vol. 4 Issue 2, p118 

    Heparin is still the major anticoagulant of choice during CPB. but it may cause thrombocytopenia and severe bleeding in patients. In light of these complications, the development of new anticoagulant drugs seemed to be necessary for these patients. Many experimental studies focused on r-hirudin,...

  • Heparin-Induced Thrombocytopenia in Patients Treated with Low-Molecular-Weight Heparin or Unfractionated Heparin. Warkentin, Theodore E.; Levine, Mark N.; Hirsh, Jack; Horsewood, Peter; Roberts, Robin S.; Gent, Michael; Kelton, John G. // New England Journal of Medicine;5/18/95, Vol. 332 Issue 20, p1330 

    Background: Heparin-induced thrombocytopenia, defined by the presence of heparin-dependent IgG antibodies, typically occurs five or more days after the start of heparin therapy and can be complicated by thrombotic events. The frequency of heparin-induced thrombocytopenia and of heparin-dependent...

  • Bivalirudin: Alternative Anticoagulation During Cardiopulmonary Bypass in Patients with Heparin-Induced Thrombocytopenia. Grubb, Kendra J.; Salehi, Payam; Chedrawy, Edgar G. // Recent Patents on Cardiovascular Drug Discovery;Jan2010, Vol. 5 Issue 1, p20 

    An estimated 1-3% of patients who receive therapeutic anticoagulation with unfractionated heparin (UFH) develop antibodies to heparin with concomitant development of thrombocytopenia, defined as HIT or Heparin-Induced Thrombocytopenia. HIT complicates the management of patients presenting for...

  • KardiohirurÅ¡ka procedúra kod bolesnika sa heparinom indukovanom trombocitopenijom (HIT II). Jović, M. D.; Nežić, D. G.; Čalija, B. M.; Nenadić, D. S.; Knežević, A. M.; Borzanović, M. D.; Krivokapić, B. M.; Petrović, I. M.; Djukanović, B. P. // Acta Chirurgica Iugoslavica;2009, Vol. 56 Issue 1, p47 

    Heparin-induced thrombocytopenia (HIT) might be life-threatening in patients undergoing open heart surgery, due to thromboembolic events, thrombocytopenia and bleeding. If cardiac surgery with cardiopulmonary bypass (CPB) is necessary, anticoagulation therapy will he based on usage of danaparoid...

  • Re: Heparin-induced thrombocytopenia--Type 2. Yagnik, Vipul D. // Asian Journal of Transfusion Science;Jul-Dec2011, Vol. 5 Issue 2, p179 

    A letter to the editor is presented in response to the article "Heparin-Induced Thrombocytopenia (HIT)-Type 2," by T. A. Majeed, published in a 2010 issue.

  • Thrombogenesis in Myocardial Infarction and Related Syndromes: The Role of Molecular Markers in Diagnosis and Management. Fareed, Jawed; Hoppensteadt, Debra A.; Leya, Fred; Lewis, Bruce; Callas, Demetra; Wolf, Helmut; Bick, Rodger L. // Clinical & Applied Thrombosis/Hemostasis;Apr1999, Vol. 5 Issue 2, p78 

    Anticoagulant therapy has undergone some major developments in recent years. Conventional drugs that produce anticoagulant effects such as heparin and oral anticoagulants are no longer considered the only candidates for the anticoagulant/antithrombotic management of patients. Recombinant...

  • Challenges encountered with argatroban anticoagulation during cardiopulmonary bypass. Agarwal, Shvetank; Ullom, Beth; Al-Baghdadi, Yasser; Okumura, Michael // Journal of Anaesthesiology Clinical Pharmacology;Jan2012, Vol. 28 Issue 1, p106 

    Use of argatroban as an alternative to heparin during cardiopulmonary bypass (CPB) in patients with heparin-induced thrombocytopenia has gained some attention in the past two decades. Dosing of argatroban during CPB is complex due to lack of complete understanding of its pharmacokinetic profile...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics