• J Clin Anesth · Sep 2016

    Case Reports

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

    • Mena M Botros, Mohamed A Mahmoud, and Andrew J Costandi.
    • University of Toledo College of Medicine, Toledo, OH, USA.
    • J Clin Anesth. 2016 Sep 1; 33: 317-9.

    AbstractLow-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. Copyright © 2016 Elsevier Inc. All rights reserved.

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