Reliable low-molecular-weight heparin reversal in a child undergoing emergency surgery: a case report

被引：1

作者：

Botros, Mena M. ^{[1
]}

Mahmoud, Mohamed A. ^{[2
]}

Costandi, Andrew J. ^{[2
,3
]}

机构：

[1] Univ Toledo, Coll Med, 2801 W Bancroft St, Toledo, OH 43606 USA

[2] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Dept Anesthesiol, Cincinnati, OH USA

[3] USC, Keck Sch Med, Dept Anesthesiol Crit Care Med, Childrens Hosp Los Angeles, 4650 Sunset Blvd,MS 3, Los Angeles, CA 90027 USA

来源：

JOURNAL OF CLINICAL ANESTHESIA | 2016年 / 33卷

关键词：

LMWH(s); Low molecular weight heparin; Enoxaparin; Protamine sulfate; Fresh frozen plasma; PROTAMINE; ANTICOAGULANT; MANAGEMENT; THROMBOSIS; ENOXAPARIN; AGENTS;

D O I：

10.1016/j.jclinane.2016.04.036

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

Low-molecular-weight heparin neutralization using protamine alone can be unreliable, especially in cases of immediate reversal for emergency surgery. Here, we describe a unique case of a 17-month-old girl with a history of glioneuronal tumor and corresponding hydrocephalus status post debulking and ventriculoperitoneal shunt placement, who was placed on enoxaparin after the development of a sagittal sinus thrombosis. Patient presented for emergency craniectomy and evacuation of subdural bleed after a fall while on therapeutic dose of enoxaparin. Protamine and fresh frozen plasma were used in the patient's perioperative course providing a reliable reversal of enoxaparin. (C) 2016 Elsevier Inc. All rights reserved.

引用

页码：317 / 319

页数：3

共 15 条

[1] Successful management of bleeding with recombinant factor Vila (NovoSeven®) in a patient with Burkitt lymphoma and thrombosis of the left femoral and left common iliac veins [J].

Culic, Srdana ;

Kuljis, Dubravka ;

Armanda, Visnja ;

Jankovic, Stipan .

PEDIATRIC BLOOD & CANCER, 2007, 49 (03) :332-335

[2] Reversal of low-molecular-weight heparin-induced bleeding in patients with pre-existing hypercoagulable states with human recombinant activated factor VII concentrate [J].

Firozvi, Kashif ;

Deveras, Ruby Anne E. ;

Kessler, Craig M. .

AMERICAN JOURNAL OF HEMATOLOGY, 2006, 81 (08) :582-589

[3]

Frontera JA, 2016, NEUROCRIT CARE, V24, P6, DOI 10.1007/s12028-015-0222-x

[4] Parenteral Anticoagulants Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [J].

Garcia, David A. ;

Baglin, Trevor P. ;

Weitz, Jeffrey I. ;

Samama, Meyer Michel .

CHEST, 2012, 141 (02) :E24S-E43S

[5]

Gatt A, 2008, THROMB HAEMOSTASIS, V100, P350

[6] Inhibition of factor VIIa generation and prothrombin activation by treatment with enoxaparin in patients with unstable angina [J].

Gerotziafas, GT ;

Zafiropoulos, A ;

Van Dreden, P ;

Karavaggeli, E ;

Goutzoumas, N ;

Nikolaidis, P ;

Combot, C ;

Lagoudaki, P ;

Zervas, K ;

Arzoglou, P ;

Samama, MM .

BRITISH JOURNAL OF HAEMATOLOGY, 2003, 120 (04) :611-617

[7] Anticoagulant and antiplatelet medications encountered in emergency surgery patients: A review of reversal strategies [J].

Gordon, Jennifer L. ;

Fabian, Timothy C. ;

Lee, Marilyn D. ;

Dugdale, Marion .

JOURNAL OF TRAUMA AND ACUTE CARE SURGERY, 2013, 75 (03) :475-486

[8] Prevention of VTE in Nonorthopedic Surgical Patients Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines [J].

Gould, Michael K. ;

Garcia, David A. ;

Wren, Sherry M. ;

Karanicolas, Paul J. ;

Arcelus, Juan I. ;

Heit, John A. ;

Samama, Charles M. .

CHEST, 2012, 141 (02) :E227S-E277S

[9] A 1-year drug utilization evaluation of protamine in hospitalized patients to identify possible future roles of heparin and low molecular weight heparin reversal agents [J].

Mahan, Charles E. .

JOURNAL OF THROMBOSIS AND THROMBOLYSIS, 2014, 37 (03) :271-278

[10] Poor reversal of low molecular weight heparin by protamine [J].

Makris, M ;

Hough, RE ;

Kitchen, S .

BRITISH JOURNAL OF HAEMATOLOGY, 2000, 108 (04) :884-885

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