Latt Htun, Aung Sammy, Kyaw Kyaw, Aung Thein Tun, Roongsritong Chanwit
Department of Internal Medicine, University of Nevada-Reno, School of Medicine, Reno, NV, USA.
Department of Heart and Vascular Health, Renown Regional Medical Center, Reno, NV, USA.
Am J Case Rep. 2017 Oct 10;18:1081-1085. doi: 10.12659/ajcr.905721.
BACKGROUND Diffuse alveolar hemorrhage (DAH) is a rare but potentially fatal complication of anticoagulant or antiplatelet therapy. Bivalirudin is a specific and reversible direct thrombin inhibitor (DTI). CASE REPORT We report a case of severe DAH, possibly related to bivalirudin use, in a 61-year-old patient undergoing coronary intervention. The patient had presented with an out-of-hospital cardiac arrest due to acute ST elevation myocardial infarction (STEMI). During the coronary intervention, shortly after receiving bivalirudin, the patient started having frank bleeding from the endotracheal tube and developed hemodynamic compromise. Despite aggressive intervention and intensive care, the patient died. CONCLUSIONS At this time, to our knowledge, there have been no reports of DAH associated with the use of bivalirudin.
背景 弥漫性肺泡出血（DAH）是抗凝或抗血小板治疗罕见但可能致命的并发症。比伐芦定是一种特异性、可逆的直接凝血酶抑制剂（DTI）。病例报告 我们报告一例61岁接受冠状动脉介入治疗的患者发生严重DAH，可能与使用比伐芦定有关。该患者因急性ST段抬高型心肌梗死（STEMI）出现院外心脏骤停。在冠状动脉介入治疗期间，患者接受比伐芦定后不久，开始出现气管内导管明显出血，并出现血流动力学不稳定。尽管进行了积极干预和重症监护，患者仍死亡。结论 据我们所知，目前尚无与使用比伐芦定相关的DAH报告。
