[Consumption coagulopathies following peritoneojugular bypass. Prevention by a heparin-antithrombin III combination].
Consumption coagulopathy (CIVD) is a frequent complication of peritoneojugular bypass operation. Preventive treatment applied involves low-dose heparin (1.5 mg/kg/d) to maintain an antithrombin III concentration of at least 65%. Results are evaluated in 6 patients treated by 7 bypass operations. A biologic CIVD developed in 2 cases (29%) but no clinical coagulopathy was observed. This incidence is less than that usually reported, a literature review indicating a biologic coagulopathy in 65% of cases, with clinical evidence in 12.5%. Furthermore, patients with spontaneously elevated AT III levels did not develop CIVD while, in contrast, sufficiently high concentrations of AT III could not be maintained in the 2 patients with coagulopathy. These findings suggest the interest of prevention of a CIVD by the use of this procedure.
D000328:Adult; D000990:Antithrombin III / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010536:Peritoneovenous Shunt / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000517:prevention & control*
D000990:Antithrombin III; D006493:Heparin
Les coagulopathies de consommation après dérivations péritonéo-jugulaires. Prévention par l'association héparine-antithrombine III.