کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2759427 1150154 2014 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Fondaparinux as a Safe Alternative for Managing Heparin-Induced Thrombocytopenia in Postoperative Cardiac Surgery Patients
ترجمه فارسی عنوان
فونداپارینوکس به عنوان جایگزین ایمن برای مدیریت ترومبوسیتوپنی ناشی از هپارین در بیماران جراحی قلب پس از عمل
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیهوشی و پزشکی درد
چکیده انگلیسی

ObjectiveHeparin-induced thrombocytopenia (HIT) is a rare but severe prothrombotic disorder of heparin treatment that leads to a decline in platelet count and thrombotic complications. If HIT is suspected, then heparin should be stopped and an alternative anticoagulant started. Fondaparinux is a factor Xa-inhibitor that is not FDA-approved for this condition, but preliminary experience in HIT patients has been reported in the literature. The present study describes an experience of anticoagulation management with fondaparinux in postoperative cardiac surgery patients.DesignRetrospective study.SettingTertiary hospital.ParticipantsPatients who had undergone cardiac surgery from October 2009 to June 2012.InterventionsAfter HIT was suspected clinically, PaGIA and ELISA test were performed in all patients to diagnose HIT. In the patients included, anticoagulation was managed with a low dose of fondaparinux and daily monitoring of platelet count and anti-Xa level.Measurements and Main ResultsOf a total of 1,338 postoperative cardiac surgery patients, 15 patients were included (1.1%). Twelve of the 15 patients with HIT presented with renal failure and were under continuous renal replacement therapy. Two major bleeding events occurred during fondaparinux treatment, although platelet count and anti-Xa activity remained within the normal range. No thrombotic episodes were diagnosed.ConclusionWith daily monitoring of anti-Xa activity, fondaparinux appeared to be a good alternative to heparin in the study group; however, randomized clinical trials are needed to establish the safety and efficacy of this drug in critically ill, previously HIT patients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Journal of Cardiothoracic and Vascular Anesthesia - Volume 28, Issue 4, August 2014, Pages 1008–1012
نویسندگان
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