A case of antithrombin replacement using recombinant human antithrombin in an adult patient supported with extracorporeal membrane oxygenation
نویسنده
چکیده
In the critically ill patient on extracorporeal life support, antithrombin production and activity can be decreased and may require replacement to therapeutic levels in order to maintain appropriate anticoagulation and prevent thrombosis.
منابع مشابه
Initial experience with recombinant antithrombin to treat antithrombin deficiency in patients on extracorporeal membrane oxygenation.
Acquired antithrombin (AT) deficiency has been associated with patients on extracorporeal membrane oxygenation (ECMO) as a result of hemodilution, blood coagulation activation, and the use of heparin. Replacement of AT has been typically utilized through the use of fresh-frozen plasma or AT concentrate. Antithrombin alfa (ATryn) is a recombinant form of AT (rAT) with an identical amino acid seq...
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Introduction: Antithrombin or antithrombin III is a vitamin K-independent, natural anticoagulant that is the major inhibitor of thrombin. With the binding of heparin, a conformational change in antithrombin occurs that increases the inactivation of thrombin by antithrombin by 4000-fold. Antithrombin deficiency can be hereditary or acquired; the acquired form is frequently encountered in patient...
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A heparin-like effect was recently described in infants, children, and adults receiving bivalirudin while supported on extracorporeal membrane oxygenation following cardiopulmonary bypass. This is most likely due to endogenous release of glycosaminoglycans from vascular endothelium and mast cells and is associated with longer duration of extracorporeal membrane oxygenation and an increased inci...
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Optimal anticoagulation plays a pivotal role in successful outcome of extracorporeal membrane oxygenation (ECMO). Heparin has been the anticoagulant of choice owing to its advantages like easy monitoring and reversibility. However, if heparin resistance is encountered, one has to decide whether to treat heparin resistance with fresh-frozen plasma or antithrombin concentrates or to choose one of...
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CONTEXT Elevated free hemoglobin (Hb) and bilirubinemia complicate extracorporeal membrane oxygenation and could affect unfractionated heparin (UH) therapy monitoring by anti-Xa assay and activated partial thromboplastin time (aPTT). OBJECTIVES To compare in vitro response of anti-Xa and aPTT assays to UH in samples with artificial hyperbilirubinemia and hyperhemoglobinemia and to estimate if...
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