The HIT treatment in a cardiac surgery patient.

Détails

ID Serval
serval:BIB_7C1277620970
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
Titre
The HIT treatment in a cardiac surgery patient.
Périodique
International journal of cardiology
Auteur(s)
Anna N., Boyan T., Kader M.A., Catherine M., Kirsch M.
ISSN
1874-1754 (Electronic)
ISSN-L
0167-5273
Statut éditorial
Publié
Date de publication
29/10/2010
Peer-reviewed
Oui
Volume
144
Numéro
3
Pages
405-407
Langue
anglais
Notes
Publication types: Case Reports ; Letter
Publication Status: ppublish
Résumé
Heparin-induced thrombocytopenia (HIT) occurs in 1 to 3% of patients after cardiac surgery. In patients with suspected or confirmed HIT, the standard of care is withheld of heparin, and an alternative, non-heparin anticoagulant substituted. An established fact is that currently only direct thrombin inhibitors (lepirudin, bivalirudin and argatroban) and heparinoids like danaparoid are approved for alternative anticoagulation in HIT patients. Herein, we report the case of a patient who developed HIT after coronary artery bypass grafting (CABG) and who was successfully treated by the factor Xa inhibitor fondaparinux. Danaparoid is our first line alternative anticoagulant to treat HIT patients. Normally the recovery from thrombocytopenia began within 24 h. In the present patient, however, platelet counts continued to fall for 3 more days. Discontinuation of danaparoid and anticoagulation with fondaparinux clearly improved platelet counts which normalized. The present patient has been treated for 26 consecutive days, and we have not observed any subsequent fall in platelet counts and any further bleeding or thrombotic complications.
Mots-clé
Anticoagulants/administration & dosage, Anticoagulants/adverse effects, Coronary Artery Bypass/adverse effects, Coronary Artery Disease/complications, Coronary Artery Disease/therapy, Diabetes Mellitus, Type 1/complications, Drug Therapy, Combination, Fondaparinux, Heparin/administration & dosage, Heparin/adverse effects, Humans, Male, Middle Aged, Platelet Count, Polysaccharides/administration & dosage, Polysaccharides/therapeutic use, Thrombocytopenia/chemically induced, Thrombocytopenia/diagnosis, Thrombocytopenia/drug therapy, Treatment Outcome
Pubmed
Web of science
Création de la notice
30/03/2019 19:04
Dernière modification de la notice
20/08/2019 15:37
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