Bioline heparin-coated ECMO with bivalirudin anticoagulation in a patient with acute heparin-induced thrombocytopenia: the immune reaction appeared to continue unabated.
Heparin-induced thrombocytopenia (HIT) is a serious, antibody-mediated complication of heparin which significantly confers risks of thrombosis and devastating outcomes. Once diagnosed, it requires immediate cessation of heparin and therapy with an alternative anticoagulant. No data are available in the literature on the pathophysiology and clinical implications of performing prolonged extracorporeal membrane oxygenation with a heparin-coated system in a patient with acute HIT treated with bivalirudin.
Pappalardo
F
F
Department of Cardiovascular Anesthesia and Intensive Care, Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy. pappalardo.federico@hsr.it
Maj
G
G
Scandroglio
A
A
Sampietro
F
F
Zangrillo
A
A
Koster
A
A
D000208:Acute Disease; D000368:Aged; D000906:Antibodies / Q000009:adverse effects / Q000276:immunology; D000925:Anticoagulants / Q000008:administration & dosage*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D006629:Hirudins / Q000008:administration & dosage*; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000601:surgery; D010446:Peptide Fragments / Q000008:administration & dosage*; D010976:Platelet Count; D011994:Recombinant Proteins / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000188:drug therapy / Q000276:immunology / Q000628:therapy*
D000906:Antibodies; D000925:Anticoagulants; D006629:Hirudins; D010446:Peptide Fragments; D011994:Recombinant Proteins; D006493:Heparin; C074619:bivalirudin