Use of ecarin clotting time (ECT) with lepirudin therapy in heparin-induced thrombocytopenia and cardiopulmonary bypass.

Abstract

Heparin-induced thrombocytopenia (HIT) is described as an allergy-like adverse reaction to heparin. It is a potentially severe complication of heparin therapy that can result in serious or life-threatening venous or arterial thromboembolic events. In the United States, lepirudin (Aventis Pharma AG, Strasbourg, France) is an approved therapy for anticoagulation in patients with HIT requiring anticoagulation. Lepirudin is a recombinant form of hirudin, a leech enzyme that is a highly specific direct inhibitor of thrombin. Lepirudin monitoring during surgery can be managed with ecarin clotting time (ECT) (Cardiovascular Diagnostics, Inc., Raleigh, NC), which has recently been approved as a humanitarian device exemption (HDE) for use in the United States in the management of HIT with cardiopulmonary bypass. This case report describes a patient with HIT who was managed successfully with lepirudin and ECT during coronary artery bypass grafting.

• Authors: M C Fabrizio
• Journal: The journal of extra-corporeal technology (J Extra Corpor Technol) Vol. 33 Issue 2 Pg. 117-25 (May 2001) ISSN: 0022-1058 [Print] United States
• PMID: 11467439 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticoagulants
• Hirudins
• Recombinant Proteins
• Heparin
• Endopeptidases
• ecarin
• lepirudin

Topics

• Anticoagulants (adverse effects, therapeutic use)
• Blood Coagulation Tests
• Cardiopulmonary Bypass
• Endopeptidases (blood)
• Heparin (adverse effects)
• Hirudin Therapy
• Hirudins (analogs & derivatives)
• Humans
• Male
• Middle Aged
• Pennsylvania
• Recombinant Proteins (therapeutic use)
• Thrombocytopenia (chemically induced)