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Intraoperative monitoring of danaparoid sodium anticoagulation during cardiovascular operations.
J Vasc Surg 1998; 27(3):568-75JV

Abstract

PURPOSE

Patients with cardiovascular disorders frequently need anticoagulation for diagnostic studies, surgical procedures, and therapy. Heparin-induced thrombocytopenia is a relatively common complication of heparin therapy that can result in thrombosis and subsequent limb loss or death, necessitating use of alternative anticoagulants.

METHODS

Two patients who needed cardiac surgery had thrombocytopenia induced by exposure to heparin and heparin-coated tubing. Several assays were examined for their ability to monitor intraoperative anticoagulation of a factor Xa inhibitor, danaparoid sodium.

RESULTS

In vitro, celite and kaolin activated dotting times and activated partial thromboplastin time were prolonged linearly in the presence of increasing concentrations of danaparoid sodium. Aprotinin did not alter the linearity of the response but did alter its slope. In vivo, activated clotting times and activated partial thromboplastin time were insensitive to clinically significant changes in danaparoid sodium plasma levels during cardiopulmonary bypass. Correction in activated partial thromboplastin time lagged 2 hours behind clinically important changes in anti-factor Xa levels. Only anti-factor Xa levels were adequate to monitor intraoperative danaparoid sodium levels.

CONCLUSION

Anticoagulation for cardiopulmonary bypass can be successfully performed with danaparoid sodium and intraoperative anti-factor Xa monitoring.

Authors+Show Affiliations

Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0640, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9546248

Citation

Gitlin, S D., et al. "Intraoperative Monitoring of Danaparoid Sodium Anticoagulation During Cardiovascular Operations." Journal of Vascular Surgery, vol. 27, no. 3, 1998, pp. 568-75.
Gitlin SD, Deeb GM, Yann C, et al. Intraoperative monitoring of danaparoid sodium anticoagulation during cardiovascular operations. J Vasc Surg. 1998;27(3):568-75.
Gitlin, S. D., Deeb, G. M., Yann, C., & Schmaier, A. H. (1998). Intraoperative monitoring of danaparoid sodium anticoagulation during cardiovascular operations. Journal of Vascular Surgery, 27(3), pp. 568-75.
Gitlin SD, et al. Intraoperative Monitoring of Danaparoid Sodium Anticoagulation During Cardiovascular Operations. J Vasc Surg. 1998;27(3):568-75. PubMed PMID: 9546248.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraoperative monitoring of danaparoid sodium anticoagulation during cardiovascular operations. AU - Gitlin,S D, AU - Deeb,G M, AU - Yann,C, AU - Schmaier,A H, PY - 1998/4/18/pubmed PY - 1998/4/18/medline PY - 1998/4/18/entrez SP - 568 EP - 75 JF - Journal of vascular surgery JO - J. Vasc. Surg. VL - 27 IS - 3 N2 - PURPOSE: Patients with cardiovascular disorders frequently need anticoagulation for diagnostic studies, surgical procedures, and therapy. Heparin-induced thrombocytopenia is a relatively common complication of heparin therapy that can result in thrombosis and subsequent limb loss or death, necessitating use of alternative anticoagulants. METHODS: Two patients who needed cardiac surgery had thrombocytopenia induced by exposure to heparin and heparin-coated tubing. Several assays were examined for their ability to monitor intraoperative anticoagulation of a factor Xa inhibitor, danaparoid sodium. RESULTS: In vitro, celite and kaolin activated dotting times and activated partial thromboplastin time were prolonged linearly in the presence of increasing concentrations of danaparoid sodium. Aprotinin did not alter the linearity of the response but did alter its slope. In vivo, activated clotting times and activated partial thromboplastin time were insensitive to clinically significant changes in danaparoid sodium plasma levels during cardiopulmonary bypass. Correction in activated partial thromboplastin time lagged 2 hours behind clinically important changes in anti-factor Xa levels. Only anti-factor Xa levels were adequate to monitor intraoperative danaparoid sodium levels. CONCLUSION: Anticoagulation for cardiopulmonary bypass can be successfully performed with danaparoid sodium and intraoperative anti-factor Xa monitoring. SN - 0741-5214 UR - https://www.unboundmedicine.com/medline/citation/9546248/Intraoperative_monitoring_of_danaparoid_sodium_anticoagulation_during_cardiovascular_operations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0741521498000883 DB - PRIME DP - Unbound Medicine ER -