[Peri-operative anticoagulation with danaparoid for a patient with Budd-Chiari syndrome and heparin-induced thrombocytopenia].
We report a case of Budd-Chiari syndrome revealing a polycythemia vera and complicated by heparin-induced thrombocytopenia. A surgical porto-caval shunt was inserted with danaparoid as anticoagulant during the peri-operative period. The doses of danaparoid were as follows: a continuous intravenous infusion of 200 U/h with a target between 0.5 et 0.8 U/ml antifactor Xa activity during the preoperative period, followed by 100 U/h with a target of 0.3 U/ml during the peroperative period; an increase in doses of danaparoid to 150 and 200 U/h with a target above 0.5 U/ml was used during the postoperative period. This case report is a rare situation of hypercoagulable state, in a surgical context, treated with danaparoid.
Département d'anesthésie-réanimation chirurgicale, CHU de Nancy-Brabois, 4, rue du Morvan, 54511 Vandoeuvre-lès-Nancy, France. bremaud@caramail.com
M
M
Brémaud
E
E
De Maistre
E
E
Junke
A
A
Guerci
J-M
JM
Lalot
D
D
Longrois
T
T
Lecompte
C
C
Meistelman
D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use*; D006502:Budd-Chiari Syndrome / Q000097:blood*; D002809:Chondroitin Sulfates / Q000627:therapeutic use*; D003871:Dermatan Sulfate / Q000627:therapeutic use*; D004338:Drug Combinations; D065427:Factor Xa Inhibitors; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006497:Heparan Sulfate / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D010974:Platelet Aggregation / Q000187:drug effects; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy*
D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D004338:Drug Combinations; D065427:Factor Xa Inhibitors; D006493:Heparin; D006497:Heparan Sulfate; C035838:danaparoid