title: Lepirudin anticoagulation for heparin-induced thrombocytopenia after cardiac surgery in a pediatric patient.
abstract: A 21-month-old boy received anticoagulation with lepirudin for heparin-induced thrombocytopenia (HIT) after undergoing cardiac surgery and receiving extracorporeal membrane oxygenation (ECMO). This report illustrates the significance of HIT in pediatric patients after cardiac surgery and the successful administration of lepirudin in this setting. To our knowledge, this is the first published report of lepirudin administered to treat HIT in a child after cardiac surgery and ECMO. Although guidelines exist that suggest the potential administration of lepirudin as treatment for children with HIT, further studies are needed to determine the safest yet most effective dosage for this population.
authors.affiliation: Department of Pharmacy, Clarian Health Partners, Riley Hospital for Children, Indianapolis, IN 46202, USA. cknoderer@clarian.org
authors.forename: Chad A
authors.initials: CA
authors.lastname: Knoderer
authors.forename: Holly M
authors.initials: HM
authors.lastname: Knoderer
authors.forename: Mark W
authors.initials: MW
authors.lastname: Turrentine
authors.forename: Manjusha
authors.initials: M
authors.lastname: Kumar
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use*; D006348:Cardiac Surgical Procedures; D002675:Child, Preschool; D004452:Echocardiography; D015199:Extracorporeal Membrane Oxygenation; D018729:Fontan Procedure; D006493:Heparin / Q000009:adverse effects*; D006629:Hirudins; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications / Q000601:surgery; D008297:Male; D010976:Platelet Count; D011183:Postoperative Complications / Q000188:drug therapy*; D011994:Recombinant Proteins / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy*
chemical_list: D000925:Anticoagulants; D006629:Hirudins; D011994:Recombinant Proteins; D006493:Heparin; C083544:lepirudin