[HSF] HIT and CPB

[EPS-CCV]

Claudia, here you can find some references about epoprostenol use in this situation. The number of patients included in these reports are small and the experience confined to very few centers, as you know, but that's the way it is. 


 References

Martzlufft F, Kuppe H, Koster A: Management of urgent high-risk cardiopulmonary bypass in patients with heparin-induced thrombocytopenia type II and coexisting disorders of renal function: use of heparin and epoprostenol combined with on-line monitoring of platelet function. J Cardiothorac Vasc Anesth 2000 Jun;14(3):304-8.

Aouifi A, Blanc P, Piriou V, et al: Cardiac surgery with cardiopulmonary bypass in patients with type II heparin-induced thrombocytopenia. Ann Thorac Surg 2001 71:678-683 

Antoniou T, Kapetanakis EI, Theodoraki K, Rellia P, Thanopoulos A, Kotiou M, Zarkalis D, Alivizatos P. Cardiac surgery in patients with heparin-induced thrombocytopenia using preoperatively determined dosages of iloprost. Heart Surg Forum. 2002;5(4):354-7.

Warkentin TE, Greinacher A: Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004 Sep;126(3 Suppl):311S-337S. Review. 

Riess FC: Anticoagulation management and cardiac surgery in patients with heparin-induced thrombocytopenia. Semin Thorac Cardiovasc Surg 2005 Spring:17(1):85-96

Keeling D, Davidson S Watson H; Haemostasis and Thrombosis Task Force of the British Committee for Standards in Haematology: The management of heparin-induced thrombocytopenia. Br J Haematol. 2006 May;133(3):259-69. (Non strong recommendation)

von Heymann C, Hagemeyer E, Kastrup M, Ziemer S, Proquitté H, Konertz WF, Spies C: Heparin-induced thrombocytopenia type II in an infant with a congenital heart defect - Anticoagulation during cardiopulmonary bypass with epoprostenol sodium and heparin. Pediatr Crit Care Med. 2006 Jul;7(4):383-5. 

HIT and alternatives to heparin. In: Perioperative Care in Cardiac Anesthesia and Surgery. Cheng DCH, David TE, eds. Philadelphia: Lippincott Williams & Wilkins, 2005:181-2.


Enrique P. de la Sota
Madrid - Spain