Cardiac surgery with cardiopulmonary bypass in patients with type II heparin-induced thrombocytopenia

Aouifi, A.; Blanc, Pascale; Piriou, Vincent; Bastien, Olivier; Ffrench, Patrick; Hanss, Michel; Lehot, Jean‐Jacques

doi:10.1016/s0003-4975(00)02022-1

Cited by 57 publications

(26 citation statements)

References 23 publications

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“…[134][135][136][137] In summary, there is no direct evidence supporting the use of one alternative nonheparin anticoagulant over another in patients with acute HIT or subacute HIT who undergo cardiac surgery. Of the alternative anticoagulants that have been used for this indication, bivalirudin is the only one that is supported by prospective, multicentre cohort studies (without internal controls) in patients with HIT and indirectly by small randomized heparin-controlled trials in patients without HIT.…”

Section: Epoprostenol Iloprost and Tirofi Banmentioning

confidence: 99%

Treatment and Prevention of Heparin-Induced Thrombocytopenia

Linkins

Dans

Moores

et al. 2012

Chest

834

335

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Section: Epoprostenol Iloprost and Tirofi Banmentioning

confidence: 99%

Treatment and Prevention of Heparin-Induced Thrombocytopenia

Linkins

Dans

Moores

et al. 2012

Chest

834

335

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“…48,[70][71][72] Various dosing regimes have been proposed for the patient and to prime the pump. Current recommendations are that anti-Xa levels should be maintained in the range of 1 U/mL throughout the procedure by intra-operative monitoring [73][74][75] with dose adjustments for bleeding or thrombosis.…”

Section: Argatrobanmentioning

confidence: 99%

Platelets: An Update on Diagnosis and Management of Thrombocytopenic Disorders

McCrae¹,

Bussel²,

Mannucci³

et al. 2001

Hematology

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Thrombocytopenia in the pregnant patient may result from a number of causes, most of which involve either immune-mediated platelet destruction or platelet consumption. Many of these disorders share clinical and laboratory features, making accurate diagnosis difficult. Moreover, uterine evacuation is indicated in the therapy of some disorders, while in others alternative interventions may allow the pregnancy to be carried to term. These and other issues are discussed as part of a comprehensive review of the differential diagnosis and management of thrombocytopenia in pregnancy.The term "refractory ITP" is used with reference to two distinct groups of patients: 1) patients in whom the platelet count cannot be easily increased, including those who are poorly responsive to initial single agent treatment, and 2) those with persistent thrombocytopenia despite the use of conventional therapies. An approach to management of the former group will be presented, followed by a discussion of patients with chronic refractory ITP. The latter will include presentation of new data on the role of Helicobacter pylori in ITP and whether its treatment ameliorates thrombocytopenia, as well as the use of rituximab and other modalities.Thrombotic microangiopathies such as thrombotic thrombocytopenic purpura (TTP) are rare, but life threatening causes of thrombocytopenia. Ultralarge multimers of von Willebrand factor (vWF) aggregate platelets intravascularly, and congenital or immune-mediated deficiencies of a metalloprotease that cleaves these ultra-large multimers may cause TTP. However, little information exists concerning the behavior of this protease in other physiological and pathological conditions. Levels of this protease have now been measured in healthy individuals of different ages, full-term newborns, pregnant women and a patients with variety of pathologic conditions, and these data will be reviewed herein.Heparin-induced thrombocytopenia/thrombosis (HIT/T) remains the most common antibodymediated, drug-induced thrombocytopenic disorder, and a leading cause of morbidity and mortality. Based on clinical correlations and murine models, there is increasing evidence that antibodies to complexes between platelet factor 4 (PF4) and heparin cause HIT/T, and the molecular composition of the relevant antigen has also become better defined. However, the introduction of sensitive ELISAs to measure anti-PF4/heparin antibodies has complicated diagnosis in some settings in which the incidence of such antibodies in unaffected patients exceeds the incidence of the disease. In addition, the FDA approval of Lepirudin and Argatroban has expanded the repertoire of agents available for therapy of HIT/T and may change the approach to management of asymptomatic patients with thrombocytopenia. However, the optimal use of these drugs in commonly encountered settings remains in evolution, and a need for alternative approaches to prevention and treatment is evident.

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“…Epoprostenol is a synthetic prostacyclin analog that inhibits platelet aggregation and has been used in HIT-positive patients undergoing cardiopulmonary bypass (CPB). 4,5 This study reports the estimated safety and efficacy of the combination of bivalirudin and epoprostenol infusions as an alternate AT regimen for VAD support from the combined pediatric experience at 2 institutions.…”

mentioning

confidence: 99%