Document Detail


Heparin-induced thrombocytopenia type II in an infant with a congenital heart defect--anticoagulation during cardiopulmonary bypass with epoprostenol sodium and heparin.
MedLine Citation:
PMID:  16738494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Heparin-induced thrombocytopenia type II (HIT II) is a rare but potentially life-threatening complication of heparin therapy. Hitherto, only few reports on HIT II in infants and children have been published. In particular, infants and children who have to be operated under cardiopulmonary bypass are at risk as an alternative anticoagulation is required. CASE PRESENTATION: We report on an infant with a congenital heart defect who was scheduled for cardiac surgery (Damus Kaye-Stansel procedure) with cardiopulmonary bypass. In the intensive care unit, an HIT II was diagnosed. Before surgery, the infant was pretreated with epoprostenol sodium (incrementally increasing up to a maximum dose of 30 ng/kg/min) before heparin was administered shortly after sternotomy. Mean arterial pressure was kept stable with an infusion of norepinephrine and the course of the cardiopulmonary bypass showed no signs of thrombosis. Drainage loss in the postoperative period was moderate. CONCLUSION: In HIT II infants, pretreatment with epoprostenol sodium before reexposure to heparin may offer a safe and effective anticoagulation for cardiopulmonary bypass.
Authors:
Christian von Heymann; Elmar Hagemeyer; Marc Kastrup; Sabine Ziemer; Hans Proquitté; Wolfgang F Konertz; Claudia Spies
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  7     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-08-10     Completed Date:  2006-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-5     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Intensive Care Medicine, Charité-University Hospital Berlin, Campus Charité Mitte, Berlin, Germany. christian.von_heymann@charite.de
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MeSH Terms
Descriptor/Qualifier:
Anticoagulants / administration & dosage,  adverse effects*
Cardiopulmonary Bypass*
Drug Therapy, Combination
Epoprostenol / administration & dosage*
Female
Heart Defects, Congenital / surgery
Heparin / administration & dosage,  adverse effects*
Humans
Infant
Platelet Aggregation Inhibitors / administration & dosage*
Premedication*
Thrombocytopenia / chemically induced*,  prevention & control*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 35121-78-9/Epoprostenol; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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