Korean J Anesthesiol.
2000 Aug;39(2):270-274. 10.4097/kjae.2000.39.2.270.
Cardiopulmonary Bypass in Patient with Heparin-Induced Thrombocytopenia Employing Recombinant Hirudin
- Affiliations
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- 1Department of Anesthesiology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
- 2Department of Cardiothoracic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
- KMID: 2031572
- DOI: http://doi.org/10.4097/kjae.2000.39.2.270
Abstract
- Heparin-induced thrombocytopenia (HIT) is a heparin-dependent antibody-mediated platelet activating syndrome frequently accompanying thrombocytopenia, thromboembolism. We experienced a case of cardiopulmonary bypass using hirudin, a direct thrombin inhibitor, in a patient with HIT. The patient who showed thrombocytopenia and thrombosis after heparin re-exposure was highly suspected of having HIT. Hirudin was used in this case as an anticoagulating agent during cardiopulmonary bypass (CPB) to prevent serious complications of heparin. Hirudin 0.3 mg/kg was mixed with a priming solution of CPB and a 0.2 mg/kg IV bolus followed by a continuous infusion of hirudin 0.15 mg/kg given for anticoagulation. After CPB, forced diuresis and platelet transfusion was performed and the patient was recovered without complication.
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