心脏移植手术中比伐鲁定耐药。

Q4 Medicine

Transplantation Reports Pub Date : 2021-03-01 DOI:10.1016/j.tpr.2020.100072

Tomasz Urbanowicz, Anna Olasińska-Wiśniewska, Marcin Ligowski, Ewa Goszczyńska, Marek Jemielity

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引用次数: 1

摘要

简介:直接凝血酶抑制剂是用于预防肝素诱导的血小板减少症(HIT)诊断后住院患者血栓性并发症的首选药物。材料与方法:我们报告一例扩张型心肌病患者在心脏移植手术中出现比伐鲁定耐药，并证实有HIT。术中给予比伐鲁定，同时行体外循环。由于ACT结果较低，最初的输注速率为2.5 mg/kg/小时，增加到4 mg/kg/小时。重复ACT成绩分别为422分、452分和468分，间隔5分钟。结论:比伐鲁定耐药虽然罕见，但在包括心脏移植在内的外科手术中，在ACT控制下的高剂量比伐鲁定可以克服耐药性。

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Bivalirudin resistance during heart transplantation surgery.

Introduction

: Direct thrombin inhibitors are drugs of choice used to prevent thrombotic complications in hospitalized patients after heparin induced thrombocytopenia (HIT) diagnosis.

Material and method

: We present a case of bivalirudin resistance in patient undergoing heart transplantation due to dilated cardiomyopathy with confirmation of HIT. Bivalirudin was given intraoperatively as cardiopulmonary bypass circulation was applied. From initial infusion rate of 2.5 mg/kg/hour, up to 4 mg/kg/hour, due to low ACT results. The repeated ACT results were 422s, 452s and 468s on 5 minutes intervals.

Conclusion

: Resistance to bivalirudin, though rare, can be overbeared by high bivalirudin dosing under ACT control during surgical procedures including heart transplantation.

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来源期刊

Transplantation Reports Medicine-Transplantation

CiteScore

0.60

自引率

0.00%

发文量

审稿时长

101 days

期刊介绍： To provide to national and regional audiences experiences unique to them or confirming of broader concepts originating in large controlled trials. All aspects of organ, tissue and cell transplantation clinically and experimentally. Transplantation Reports will provide in-depth representation of emerging preclinical, impactful and clinical experiences. -Original basic or clinical science articles that represent initial limited experiences as preliminary reports. -Clinical trials of therapies previously well documented in large trials but now tested in limited, special, ethnic or clinically unique patient populations. -Case studies that confirm prior reports but have occurred in patients displaying unique clinical characteristics such as ethnicities or rarely associated co-morbidities. Transplantation Reports offers these benefits: -Fast and fair peer review -Rapid, article-based publication -Unrivalled visibility and exposure for your research -Immediate, free and permanent access to your paper on Science Direct -Immediately citable using the article DOI