Bioline® heparin-coated ECMO with bivalirudin anticoagulation in a patient with acute heparin-induced thrombocytopenia: the immune reaction appeared to continue unabated
Restricted accessResearch articleFirst published online March, 2009
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.
1 Aldea GS Soltow LO Chandler WL . Limitation of thrombin generation, platelet activation, and inflammation by elimination of cardiotomy suction in patients undergoing coronary artery bypass grafting treated with heparin-bonded circuits. J Thorac Cardiovasc Surg.2002; 123: 742–755.
2.
2 Warkentin TE Greinacher A . Heparin-induced thrombocytopenia and cardiac surgery. Ann Thorac Surg.2003; 76(6): 2121–2131 Review.
3.
3 Koster A Huebler S Potapov E . Impact of heparin-induced thrombocytopenia on outcome in patients with ventricular assist device support: a single-institution experience in 358 consecutive patients. Ann Thorac Surg2007; 83: 72–76.
4.
4 Koster A Loebe M Sodian R . Heparin antibodies and thromboembolism in heparin-coated and noncoated ventricular assist devices. J Thorac Cardiovasc Surg2001; 121(2): 331–335.
5.
5 Veale JJ McCarthy HM Palmer G Dyke CM . Use of bivalirudin as an anticoagulant during cardiopulmonary bypass. J Extra Corpor Technol.2005; 37: 296–302.
