Monitoring of hirudin therapy with the Thrombelastograph.
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.
Pivalizza
Evan G
EG
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
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
D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin