Argueta-Morales I Ricardo, Olsen Monica C, DeCampli William M, Munro Hamish M, Felix Donald E
The Heart Center at Arnold Palmer Hospital for Children, Orlando, Florida 32806, USA.
J Extra Corpor Technol. 2012 Jun;44(2):69-74.
Patients with heparin-induced thrombocytopenia (HIT) that require anticoagulation for cardiovascular procedures represent a challenging and high-risk group. Bivalirudin and argatroban have been successfully used as alternative anticoagulants in adult patients with HIT. There have been few experiences published involving the pediatric population and controversy exists regarding the properties and optimal dosing of these drugs. This report describes the experience of managing two pediatric patients with HIT that underwent cardiovascular procedures requiring anticoagulation. Bivalirudin was used in both cases for anticoagulation during cardiopulmonary bypass, while argatroban was used without complications during cardiac catheterization. A description of perfusion and anticoagulation protocols is included.
因心血管手术需要抗凝治疗的肝素诱导的血小板减少症（HIT）患者是一个具有挑战性的高风险群体。比伐卢定和阿加曲班已成功用作成年HIT患者的替代抗凝剂。涉及儿科人群的相关经验报道较少，并且关于这些药物的特性和最佳剂量存在争议。本报告描述了管理两名接受需要抗凝治疗的心血管手术的儿科HIT患者的经验。两例患者在体外循环期间均使用比伐卢定进行抗凝，而在心脏导管插入术期间使用阿加曲班且未出现并发症。文中还包括了灌注和抗凝方案的描述。
