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A case report of heparin resistance due to acquired antithrombin III deficiency.

Abstract
A case of heparin resistance and its management during cardiopulmonary bypass is reported. A patient with a history of post-infarct angina and arrhythmias was treated with intravenous heparin infusion for five days prior to myocardial revascularisation surgery. He required 13,500 IU/kg of heparin to increase his activated clotting time to a therapeutic level for safe institution of cardiopulmonary bypass. This phenomenon of heparin resistance was postulated to be due to consumption of circulating antithrombin III as a result of prior heparinisation. Treatment with fresh frozen plasma restored heparin effectiveness.
AuthorsC K Leong, B C Ong
JournalAnnals of the Academy of Medicine, Singapore (Ann Acad Med Singap) Vol. 27 Issue 6 Pg. 877-9 (Nov 1998) ISSN: 0304-4602 [Print] Singapore
PMID10101569 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anticoagulants
  • Heparin
Topics
  • Aged
  • Anticoagulants (administration & dosage, adverse effects)
  • Antithrombin III Deficiency (chemically induced)
  • Blood Coagulation (drug effects)
  • Cardiopulmonary Bypass
  • Drug Resistance
  • Heparin (administration & dosage, adverse effects)
  • Humans
  • Infusions, Intravenous
  • Male
  • Whole Blood Coagulation Time

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