title: A novel method for the management of patients with heparin-induced thrombocytopaenia during cardiac surgery.
abstract: A 63-year old, male patient presented with prosthetic valve endocarditis and developed heparin-induced thrombocytopaenia (HIT) following heparin administration for continuous veno-venous haemofiltration. Use of cardiopulmonary bypass in patients suffering from heparin-induced thrombocytopaenia is difficult and challenging. We report a novel method that allows heparin use in patients diagnosed with HIT using Multiplate platelet analyser and iloprost. Platelet function analysis is complex, poorly standardized and time consuming. Multiplate platelet analyser represents a convenient, safe, reliable and rapid system that allows the assessment of platelet dysfunction. It allows objective demonstration of platelet inhibition before administration of heparin, allowing safe establishment of cardiopulmonary bypass in patients suffering from HIT.
authors.affiliation: Department of Cardiothoracic Surgery, Heart and Lung Centre, Wolverhampton , UK mishrapk_25@yahoo.com.
authors.forename: Pankaj Kumar
authors.initials: PK
authors.lastname: Mishra
authors.affiliation: Department of Cardiothoracic Surgery, Heart and Lung Centre, Wolverhampton , UK.
authors.forename: Asterinos
authors.initials: A
authors.lastname: Chnaris
authors.affiliation: Department of Cardiac Anaesthesia, Heart and Lung Centre, Wolverhampton, UK.
authors.forename: Fayaz
authors.initials: F
authors.lastname: Mohammed
authors.affiliation: Department of Cardiothoracic Surgery, Heart and Lung Centre, Wolverhampton , UK.
authors.forename: Heyman
authors.initials: H
authors.lastname: Luckraz
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass; D004696:Endocarditis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D016285:Iloprost / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D010979:Platelet Function Tests; D012086:Reoperation; D013921:Thrombocytopenia / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D016285:Iloprost
keywords: Cardiopulmonary bypass; Heparin; Heparin-induced thrombocytopaenia; Multiplate platelet analyser; Platelet assessment; Platelet dysfunction