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使用比伐卢定抗凝的静脉-静脉体外膜肺氧合进行血浆置换。

Plasma exchange on venovenous extracorporeal membrane oxygenation with bivalirudin anticoagulation.

作者信息

Preston Thomas J, Dalton Heidi J, Nicol Kathleen K, Ferrall Brit R, Miller Julie C, Hayes Don

机构信息

Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA Heart Center, Nationwide Children's Hospital, Columbus, OH, USA Department of Cardiovascular Perfusion and ECMO, Nationwide Children's Hospital, Columbus, OH, USA

Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix Children's Hospital, Phoenix, AZ, USA.

出版信息

World J Pediatr Congenit Heart Surg. 2015 Jan;6(1):119-22. doi: 10.1177/2150135114553476.

Abstract

A pediatric patient requiring venovenous (VV) extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation developed heparin-induced thrombocytopenia. Unfractionated heparin was discontinued, and a bivalirudin infusion was started. During the lung transplant evaluation, he was found to have allosensitization, requiring treatment with plasma exchange along with pulse methylprednisolone, rituximab, bortezomib, and pooled immunoglobulin infusion. We describe our experience with successful plasma exchange for allosensitization during bivalirudin anticoagulation on VV ECMO in a pediatric patient.

摘要

一名需要静脉-静脉(VV)体外膜肺氧合(ECMO)作为肺移植过渡的儿科患者发生了肝素诱导的血小板减少症。普通肝素停用,开始输注比伐芦定。在肺移植评估期间,发现他存在同种致敏,需要进行血浆置换,并联合静脉注射甲泼尼龙、利妥昔单抗、硼替佐米以及输注静脉注射用人免疫球蛋白进行治疗。我们描述了在一名儿科患者的VV ECMO上使用比伐芦定抗凝期间成功进行血浆置换治疗同种致敏的经验。

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