• J Extra Corpor Technol · Jun 2012

    Case Reports

    Alternative anticoagulation during cardiovascular procedures in pediatric patients with heparin-induced thrombocytopenia.

    • I Ricardo Argueta-Morales, Monica C Olsen, William M DeCampli, Hamish M Munro, and Donald E Felix.
    • The Heart Center at Arnold Palmer Hospital for Children, Orlando, Florida 32806, USA.
    • J Extra Corpor Technol. 2012 Jun 1; 44 (2): 69-74.

    AbstractPatients with heparin-induced thrombocytopenia (HIT) that require anticoagulation for cardiovascular procedures represent a challenging and high-risk group. Bivalirudin and argatroban have been successfully used as alternative anticoagulants in adult patients with HIT. There have been few experiences published involving the pediatric population and controversy exists regarding the properties and optimal dosing of these drugs. This report describes the experience of managing two pediatric patients with HIT that underwent cardiovascular procedures requiring anticoagulation. Bivalirudin was used in both cases for anticoagulation during cardiopulmonary bypass, while argatroban was used without complications during cardiac catheterization. A description of perfusion and anticoagulation protocols is included.

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