Preoperative detection and management of immune heparin-induced thrombocytopenia in patients undergoing heart surgery with iloprost

Palatianos, George M.; Foroulis, Christophoros N.; Vassili, Maria; Matsouka, Phaedra; Astras, George; Kantidakis, George H.; Iliopoulou, Eugenia; Melissari, E.

doi:10.1016/j.jtcvs.2003.08.042

Cited by 32 publications

(21 citation statements)

References 19 publications

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“…1,2 However, according to the results of previous experimental studies, the immediate postoperative administration of 5-FU plus LV impairs wound healing on colonic anastomosis and results in a higher incidence of anastomotic failure after colon resection. 3,4 Iloprost (ILOMEDIN \ , Schering Berlin, Germany), a stable analog of prostaglandin I 2 is a potent vasodilator, 5 an inhibitor of thrombocyte aggregation, 5,6 and also exerts cytoprotective 7,8 and antimetastatic effects. 9,10 According to these properties, we hypothesized that iloprost could enhance the healing process and counteract the impaired anastomotic healing caused by 5-FU/LV administration.…”

mentioning

confidence: 99%

Effect of Iloprost on Impaired Anastomotic Healing Caused by 5-Fluorouracil plus Leucovorin

Vasiliadis

Pramateftakis

Blouhos

et al. 2007

Diseases of the Colon &Amp; Rectum

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mentioning

confidence: 99%

Effect of Iloprost on Impaired Anastomotic Healing Caused by 5-Fluorouracil plus Leucovorin

Vasiliadis

Pramateftakis

Blouhos

et al. 2007

Diseases of the Colon &Amp; Rectum

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“…Rational pharmacologic approaches would potentially include anti-platelet agents (glycoprotein IIb/IIIa inhibitors, prostacyclin) in conjunction with DTI administration to attenuate thrombin-mediated platelet activation. Specifically, administration of epoprostenol 24 or iloprost 25 and heparin to patients with HIT undergoing CPB has been performed successfully. Further, administration of the short-acting glycoprotein IIb/IIIa inhibitor tirofiban in conjunction with hirudin 26,27 resulted in no apparent patient injury after CPB.…”

mentioning

confidence: 99%

Argatroban, Bivalirudin, and Lepirudin do not Decrease Clot Propagation and Strength as Effectively as Heparin-activated Antithrombin In Vitro

Nielsen

Steenwyk

Gurley

et al. 2006

The Journal of Heart and Lung Transplantation

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“…The antiplatelet effect of iloprost is short-lived, and iloprost is rapidly eliminated. 25,26) Indeed, the results of bleeding requiring revision did not differ between the groups significantly in our study.…”

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confidence: 40%

Effect of Iloprost on Renal Function in Patients Undergoing Coronary Artery Bypass Grafting: A Clinical Study

Darçin

Zor

Şahin

et al. 2013

Ann Thorac Cardiovasc Surg

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Purpose: Renal dysfunction remains a serious complication of coronary artery bypass grafting (CABG) surgery and is associated with increased mortality and morbidity. To date, a number of different strategies, including new pharmacologic agents, off-pump and cardiopulmonary bypass techniques have been used to avoid it, but none of them proves the excellent result. Methods: Between April 2009 to September 2011, 185 consecutive patients with multivessel coronary artery disease undergoing elective CABG were included the study. Iloprost was given with the onset of rewarming period at a dose of 1.25-2.5 ng/kg/min and it was ended together with the ending of CPB in 94 patients and remaining were in the control group. Creatinine clearance (CCr) and GFR were measured at the time of hospitalisation and on day first and fifth postoperatively. Serum potassium level was determined every 6 hours, during the first 24 hours postoperatively, and every 12 hours for the next 72 hours, and glomerular filtration rate was estimated. Results: There was no statistically significant difference in preoperative comorbidity. There were no significant differences in postoperative morbidity or mortality between either of the two groups that completed the study. However, urine output during the operation was significantly higher in the study group. An increase in creatine levels was more common in the control group. Development of a new CCr less than 50 ml/min was also significantly higher in the control group, postoperatively. Conclusion: Our study demonstrates that prophylactic intravenous iloprost administration after initiation of a rewarming period during CPB in patients undergoing CABG surgery is associated with improved renal function, compared with conventional treatment in wellhydrated patients. It also has a good safety profile and is generally well tolerated.

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Preoperative detection and management of immune heparin-induced thrombocytopenia in patients undergoing heart surgery with iloprost

Abstract: Immune heparin-induced thrombocytopenia can be detected preoperatively among patients with a low platelet count or a history of prolonged heparin exposure or both. Cardiac surgery can be safely undertaken using iloprost-induced platelet inhibition during heparinization.

Cited by 32 publications

References 19 publications

Effect of Iloprost on Impaired Anastomotic Healing Caused by 5-Fluorouracil plus Leucovorin

Effect of Iloprost on Impaired Anastomotic Healing Caused by 5-Fluorouracil plus Leucovorin

Argatroban, Bivalirudin, and Lepirudin do not Decrease Clot Propagation and Strength as Effectively as Heparin-activated Antithrombin In Vitro

Effect of Iloprost on Renal Function in Patients Undergoing Coronary Artery Bypass Grafting: A Clinical Study

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