Delayed thrombin generation is not associated with fibrinopeptide formation during prolonged cardiopulmonary bypass with hirudin anticoagulation.
Patients with heparin-induced thrombocytopenia urgently requiring surgery with cardiopulmonary bypass (CPB) present a unique management challenge that must be addressed by the use of alternative anticoagulants. Although clinical success with the direct thrombin inhibitor hirudin has been reported, there is sparse information in the literature supporting the efficacy of this drug as an anti-thrombotic to prevent fibrin formation during CPB. In this report, we describe the efficacy of this drug to prevent thrombin-mediated fibrin formation during CPB.
Belway
D
D
Department of Cardiovascular Perfusion, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Rubens
F D
FD
Henley
B
B
Babaev
A
A
Mesana
T
T
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D002809:Chondroitin Sulfates / Q000009:adverse effects; D000075202:Contraindications; D003871:Dermatan Sulfate / Q000009:adverse effects; D004691:Endarterectomy; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005344:Fibrinopeptide A / Q000032:analysis / Q000096:biosynthesis*; D006493:Heparin; D006497:Heparan Sulfate / Q000009:adverse effects; D006629:Hirudins / Q000008:administration & dosage; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D007036:Hypothermia, Induced; D008297:Male; D010446:Peptide Fragments / Q000032:analysis; D011183:Postoperative Complications / Q000517:prevention & control; D011516:Prothrombin / Q000032:analysis; D011655:Pulmonary Embolism / Q000150:complications / Q000601:surgery*; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000139:chemically induced; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D017131:Thrombectomy; D013917:Thrombin / Q000096:biosynthesis*; D013927:Thrombosis / Q000517:prevention & control
D000925:Anticoagulants; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D005343:Fibrinolytic Agents; D005344:Fibrinopeptide A; D006493:Heparin; D006497:Heparan Sulfate; D006629:Hirudins; D010446:Peptide Fragments; D011516:Prothrombin; D011994:Recombinant Proteins; D013917:Thrombin; C045879:prothrombin fragment 1.2; C035838:danaparoid; C083544:lepirudin