An infrequent complication of a not so infrequent disease. Hit by HIT

2018 ◽  
Vol 27 (2) ◽  
pp. 124-126 ◽  
Author(s):  
Elena Sandoval ◽  
María Ascaso ◽  
Eduard Quintana ◽  
Daniel Pereda
Keyword(s):  
Membrane Oxygenator ◽  
Heparin Induced Thrombocytopenia ◽  
Vascular Thrombosis ◽  
Sudden Drop ◽  
Coronary Syndrome ◽  
Extracorporeal Membrane Oxygenator ◽  
Tissue Valve ◽  
Valve Thrombosis ◽  
Heparin Exposure ◽  
Uncommon Complication

Heparin-induced thrombocytopenia is not uncommon in cardiac surgery. Thrombosis is the most frequent complication. A 77-year-old man suffered cardiac arrest due to right coronary emboli. Transesophageal echocardiography revealed tissue valve thrombosis. He required support with an extracorporeal membrane oxygenator that also thrombosed. Heparin-induced thrombocytopenia was diagnosed, and anticoagulation was switched to argatroban. Heparin- induced thrombocytopenia normally presents as vascular thrombosis. In this case, the first symptom was tissue valve thrombosis causing an acute coronary syndrome. It is not an uncommon complication and should be considered if unexpected thrombosis and a sudden drop in platelet count develops after heparin exposure.

scholarly journals How I treat patients with a history of heparin-induced thrombocytopenia

Blood ◽  
2016 ◽  
Vol 128 (3) ◽  
pp. 348-359 ◽  
Author(s):  
Theodore E. Warkentin ◽  
Julia A. M. Anderson
Keyword(s):  
Oral Anticoagulants ◽  
Chronic Hemodialysis ◽  
Short Term ◽  
Heparin Induced Thrombocytopenia ◽  
Coronary Syndrome ◽  
History Of ◽  
Minimum Interval ◽  
Direct Acting ◽  
Or History ◽  
Heparin Exposure

Abstract Heparin-induced thrombocytopenia (HIT) is a relatively common prothrombotic adverse drug reaction of unusual pathogenesis that features platelet-activating immunoglobulin G antibodies. The HIT immune response is remarkably transient, with heparin-dependent antibodies no longer detectable 40 to 100 days (median) after an episode of HIT, depending on the assay performed. Moreover, the minimum interval from an immunizing heparin exposure to the development of HIT is 5 days irrespective of the patient’s previous heparin exposure status or history of HIT. This means that short-term heparin reexposure can be safely performed if platelet-activating antibodies are no longer detectable at reexposure baseline and is recommended when heparin is the clear anticoagulant of choice, such as for cardiac or vascular surgery. The risk of recurrent HIT 1 to 2 weeks after heparin reexposure is ∼2% to 5% and is attributable to formation of delayed-onset (or autoimmune-like) HIT antibodies that activate platelets even in the absence of pharmacologic heparin. Some studies suggest that longer-term heparin reexposure (eg, for chronic hemodialysis) may also be reasonable. However, for other antithrombotic indications that involve patients with a history of HIT (eg, treatment of venous thromboembolism or acute coronary syndrome), preference should be given to non-heparin agents such as fondaparinux, danaparoid, argatroban, bivalirudin, or one of the new direct-acting oral anticoagulants as appropriate.

Platelet Count Trends and Prevalence of Heparin-Induced Thrombocytopenia in a Cohort of Extracorporeal Membrane Oxygenator Patients

2016 ◽  
Vol 44 (11) ◽  
pp. e1031-e1037 ◽  
Author(s):  
Mladen Sokolovic ◽  
Alexandra K. Pratt ◽  
Vladimir Vukicevic ◽  
Molly Sarumi ◽  
Laura S. Johnson ◽  
...  
Keyword(s):  
Platelet Count ◽  
Membrane Oxygenator ◽  
Heparin Induced Thrombocytopenia ◽  
Extracorporeal Membrane Oxygenator

scholarly journals Goodpasture's-Like Syndrome and Effect of Extracorporeal Membrane Oxygenator Support.

1994 ◽  
Vol 33 (9) ◽  
pp. 569-573 ◽  
Author(s):  
Shoichiro DAIMON ◽  
Tomoya UMEDA ◽  
Ichiro Ichiro MICHISHITA ◽  
Harue WAKASUGI ◽  
Akira GENDA ◽  
...  
Keyword(s):  
Membrane Oxygenator ◽  
Extracorporeal Membrane Oxygenator

Comparison of outcomes of infants with giant omphaloceles over two decades

2020 ◽  
pp. 1-5
Author(s):  
R.E. Witt ◽  
M. Singhal ◽  
A.J. Vachharajani
Keyword(s):  
Mechanical Ventilation ◽  
Medical Records ◽  
Invasive Mechanical Ventilation ◽  
Informed Decision Making ◽  
Membrane Oxygenator ◽  
Associated Anomalies ◽  
Single Institution ◽  
Extracorporeal Membrane Oxygenator ◽  
Pulmonary Vasodilators ◽  
Improved Outcomes

BACKGROUND: The purpose of this study was to compare the outcomes of infants with giant omphalocele (GO) born in two different epochs over two decades at a single institution. Specifically, it examined whether the utilization of selective pulmonary vasodilators and extracorporeal membrane oxygenator (ECMO) in the management of pulmonary hypertension in the second epoch were associated with improved outcomes. METHODS: The medical records of all patients diagnosed with GO at a large children’s hospital from January 1, 1996 to December 31, 2016 were reviewed and divided into two epochs. Patients were classified as having an isolated GO or GO with minor or major associated anomalies. GO was defined as a defect more than or equal to 5 cm in size and/or liver in the sac. RESULTS: During the study period, 59 infants with GO were identified. The duration of invasive mechanical ventilation was significantly shorter among the survivors from the second epoch (p = 0.03), with none greater than seven days. There were no significant differences in the outcomes of survival to NICU discharge and length of stay (LOS) between infants in the two epochs. CONCLUSIONS: Infants with GO who required invasive mechanical ventilation for more than seven days did not survive in the second epoch. Survival did not improve with uses of selective pulmonary vasodilators and ECMO. This information could be shared with families during prenatal and postnatal counselling to facilitate informed decision making regarding goals of care.

Levosimendan in veno‐arterial extracorporeal membrane oxygenator supported patients: impact on the success of weaning and survival

2020 ◽  
Author(s):  
Marta Alonso‐Fernandez‐Gatta ◽  
Soraya Merchan‐Gomez ◽  
Miryam Gonzalez‐Cebrian ◽  
Alejandro Diego‐Nieto ◽  
Elisabete Alzola ◽  
...  
Keyword(s):  
Membrane Oxygenator ◽  
Extracorporeal Membrane Oxygenator

Native aortic valve thrombosis due to heparin-induced thrombocytopenia

2021 ◽  
Author(s):  
Yu Inaba ◽  
Yasunori Iida ◽  
Hidetoshi Oka ◽  
Takahisa Miki ◽  
Takashi Hachiya ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Heparin Induced Thrombocytopenia ◽  
Native Aortic Valve ◽  
Valve Thrombosis

A Miniaturized Extracorporeal Membrane Oxygenator with Integrated Rotary Blood Pump: Preclinical In Vivo Testing

ASAIO Journal ◽  
2011 ◽  
Vol 57 (3) ◽  
pp. 158-163 ◽  
Author(s):  
Ruedger Kopp ◽  
Ralf Bensberg ◽  
Jutta Arens ◽  
Ulrich Steinseifer ◽  
Thomas Schmitz-Rode ◽  
...  
Keyword(s):  
Blood Pump ◽  
Membrane Oxygenator ◽  
Rotary Blood Pump ◽  
Extracorporeal Membrane Oxygenator ◽  
In Vivo Testing
Sign in / Sign up

Export Citation Format

Share Document