Heparin-induced thrombocytopenia and the use of r-hirudin during cardiopulmonary bypass.
We report the successful use of r-hirudin (lepirudin) for cardiopulmonary bypass in a 67-year-old man who developed heparin-induced thrombocytopenia type II during heparin treatment of an extensive deep venous thrombosis. Lepirudin was monitored by the modified ecarin clotting time in a "mobile laboratory" set up next to the cardiac theatre, aiming for lepirudin levels of 3.5 to 4.5 microg/ml during bypass.
Manikappa
S
S
Department of Anaesthesia, Monash Medical Centre, Clayton, Victoria.
Benfield
K
K
Gan
T E
TE
Butler
J
J
Malan
E
E
Tran
H A M
HA
Tucker
A
A
D000368:Aged; D002315:Cardiopulmonary Bypass; D006493:Heparin / Q000009:adverse effects*; D024764:Hirudin Therapy; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000145:classification; D020246:Venous Thrombosis / Q000188:drug therapy
D006493:Heparin