Lifesaving citrate anticoagulation to bridge ineffective danaparoid [correction of to bridge to danaparoid] treatment.
A case of successful regional anticoagulation with trisodium citrate in a patient who developed heparin-induced thrombocytopenia while on continuous hemofiltration is described. Immediate citrate anticoagulation allowed for maintenance of extracorporeal circulation until effective danaparoid therapy could be established. Recommended plasma antifactor Xa levels for hemodialysis may be inadequate in some cases. Values similar to those in use during cardiopulmonary bypass could be required.
Dworschak
Martin
M
Department of Cardiothoracic Anesthesia and Intensive Care, University Hospital Vienna, Austria. dworschak.martin@mayo.edu
Hiesmayr
Jörg Michael
JM
Lassnigg
Andrea
A
D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D002809:Chondroitin Sulfates / Q000008:administration & dosage* / Q000009:adverse effects; D019343:Citric Acid / Q000008:administration & dosage* / Q000009:adverse effects; D003871:Dermatan Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D004630:Emergencies; D065427:Factor Xa Inhibitors; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000601:surgery*; D006440:Hemofiltration; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006497:Heparan Sulfate / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010976:Platelet Count; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced*
D000925:Anticoagulants; D002809:Chondroitin Sulfates; D019343:Citric Acid; D003871:Dermatan Sulfate; D004338:Drug Combinations; D065427:Factor Xa Inhibitors; D006493:Heparin; D006497:Heparan Sulfate; C035838:danaparoid