title: Monitoring of hirudin therapy with the Thrombelastograph.
abstract: Lepirudin is a specific thrombin inhibitor that is used for anticoagulation in patients with heparin-induced thrombocytopenia who are also undergoing cardiopulmonary bypass (CPB). Monitoring of lepirudin during CPB has been carried out with activated clotting time and ecarin clotting time. Correlation is poor with the former method, whereas ecarin clotting time is not widely available. A patient is described with heparin-induced thrombocytopenia who underwent CPB, where coagulation monitoring was accomplished with the Thrombelastograph. This more widely available method may be useful in such patients.
authors.affiliation: Department of Anesthesiology, University of Texas Health Science Center at Houston, MSB 5.020, 6431 Fannin Street, Houston, TX 77030, USA. Evan.G.Pivalizza@uth.tmc.edu
authors.forename: Evan G
authors.initials: EG
authors.lastname: Pivalizza
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass; D016903:Drug Monitoring; D006493:Heparin / Q000009:adverse effects; D006629:Hirudins / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use*; D013916:Thrombelastography; D013921:Thrombocytopenia / Q000139:chemically induced; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin