Pediatric heparin-induced thrombocytopenia: management with Danaparoid (orgaran).
Heparin-induced thrombocytopenia is a rare and serious complication of anticoagulation therapy. There remains a paucity of information pertaining to alternative anticoagulation strategies for use during cardiopulmonary bypass concomitant with heparin-induced thrombocytopenia, especially in children. We report the successful treatment of heparin-induced thrombocytopenia and subsequent hemorrhagic complications postoperatively in a 2-year-old child with Danaparoid (orgaran). Emergent conduit revision with cardiopulmonary bypass was required for a thrombosed systemic-venous to pulmonary-arterial connection (completion modified Fontan procedure). Required doses of Danaparoid were consistently twofold that previously reported for adults.
Saxon
B R
BR
Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada.
Black
M D
MD
Edgell
D
D
Noel
D
D
Leaker
M T
MT
D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002315:Cardiopulmonary Bypass; D002675:Child, Preschool; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D003871:Dermatan Sulfate / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery; D006470:Hemorrhage / Q000188:drug therapy; D006493:Heparin / Q000009:adverse effects*; D006497:Heparan Sulfate / Q000627:therapeutic use*; D006801:Humans; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000188:drug therapy*; D013927:Thrombosis / Q000188:drug therapy / Q000209:etiology
D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D006493:Heparin; D006497:Heparan Sulfate; C035838:danaparoid