Assembly of the Heparin Removal Device for patients with suspected adverse reaction to protamine sulphate

Détails

ID Serval
serval:BIB_6B2C9C78A150
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Assembly of the Heparin Removal Device for patients with suspected adverse reaction to protamine sulphate
Périodique
Perfusion
Auteur⸱e⸱s
Jegger  D., Tevaerai  H. T., Horisberger  J., Mueller  X. M., Seigneuil  I., Pierrel  N., Boone  Y., von Segesser  L. K.
ISSN
0267-6591 (Print)
Statut éditorial
Publié
Date de publication
09/2000
Volume
15
Numéro
5
Pages
453-6
Notes
Case Reports
Journal Article --- Old month value: Sep
Résumé
Protamine sulphate is routinely used after cardiopulmonary bypass (CPB) to restore the patient's baseline coagulatory state. However, adverse reactions are encountered, and alternative means to neutralize heparin are, therefore, necessary. The Heparin Removal Device (HRD) constitutes an extracorporeal circuit that allows ex vivo deheparinization by mean of a polycationic ligand that binds heparin molecules. This paper presents the setup of the HRD circuit. It is illustrated by the report of a 68-year-old man with a known severe crustacean allergy. The patient (78 kg, 170 cm) was admitted for elective coronary artery bypass graft surgery. It was decided that the HRD would be used as a precaution in order to avoid the risks of using protamine sulphate. The CPB time and aortic crossclamp time were 70 and 40 min, respectively. At the end of CPB, the device was inserted and processing started. Activated coagulation time values were monitored over a 130 min period and diminished from 480 to 300 s after 45 min, 220 s after 90 min, and settled at 150 s. Haemostasis was acceptable and processing stopped. The operation was terminated and the patient transferred to the intensive care unit. Clinical evolution was excellent, with minimal postoperative bleeding. The HRD presents an alternative to protamine sulphate when this drug is contraindicated for a certain patient population who might have a suspected, known or emergency adverse reaction.
Mots-clé
Aged Blood Coagulation Tests Cardiopulmonary Bypass/methods Cations/metabolism Drug Hypersensitivity/etiology/*prevention & control *Equipment and Supplies Extracorporeal Circulation/instrumentation/*methods Hemostasis/drug effects Heparin/*blood/metabolism Humans Ligands Male Protamines/*adverse effects/blood/contraindications
Pubmed
Web of science
Création de la notice
28/01/2008 10:28
Dernière modification de la notice
20/08/2019 15:25
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