Baccellieri Domenico, Bilman Victor, Apruzzi Luca, Monaco Fabrizio, D'Angelo Armando, Loschi Diletta, Melissano Germano, Chiesa Roberto
Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Department of Vascular Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Ann Vasc Surg. 2020 Oct;68:88-92. doi: 10.1016/j.avsg.2020.06.046. Epub 2020 Jun 24.
Heparin resistance is an uncommon phenomenon defined as the need for high-dose unfractionated heparin (UFH) of more than 35,000 IU/day to achieve the target activated partial-thromboplastin time ratio or the failure to achieve the desired activated clotting time after a full UFH dose. This rare phenomenon is being more commonly observed in Covid-19 patients in a hypercoagulable state. We describe a Covid-19 patient confirmed by reverse-transcriptase polymerase chain reaction assay, with acute limb ischemia, who developed heparin resistance. The patient was managed by the departments of vascular surgery, anesthesia and intensive care, and the Coagulation Service and Thrombosis Research from San Raffaele Scientific Institute, Milan, Italy.
肝素抵抗是一种不常见的现象，定义为需要超过35,000 IU/天的高剂量普通肝素（UFH）才能达到目标活化部分凝血活酶时间比值，或在给予全剂量UFH后未能达到所需的活化凝血时间。这种罕见现象在处于高凝状态的新冠肺炎患者中越来越常见。我们描述了一名经逆转录酶聚合酶链反应检测确诊为新冠肺炎、患有急性肢体缺血且出现肝素抵抗的患者。该患者由血管外科、麻醉科和重症监护科以及意大利米兰圣拉斐尔科学研究所的凝血服务和血栓形成研究部门进行治疗。
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