Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization
Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotti...
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| Autor*in: |
Iqbal, O. - M.D. Tobu, M. - M.D. Aziz, S. - M.D. Gerdisch, M. - M.D. Da Valle, M. - M.D. Demir, M. - M.D. Hoppensteadt, D.A. - Ph.D. Ahmad, S. - Ph.D. Walenga, J.M. - Ph.D. Fareed, J. - Ph.D. |
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E-Artikel |
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350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England .: Blackwell Science Inc ; 2005 |
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Online-Ressource |
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| Reproduktion: |
2005 ; Blackwell Publishing Journal Backfiles 1879-2005 |
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| Übergeordnetes Werk: |
In: Journal of cardiac surgery - Oxford : Wiley-Blackwell, 1986, 20(2005), 1, Seite 0 |
| Übergeordnetes Werk: |
volume:20 ; year:2005 ; number:1 ; pages:0 |
| Links: |
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| DOI / URN: |
10.1111/j.0886-0440.2005.200316.x |
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NLEJ243083971 |
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| 245 | 1 | 0 | |a Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization |
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| 520 | |a Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. | ||
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| 700 | 1 | |a Iqbal, O. |c M.D. |4 oth | |
| 700 | 1 | |a Tobu, M. |c M.D. |4 oth | |
| 700 | 1 | |a Aziz, S. |c M.D. |4 oth | |
| 700 | 1 | |a Gerdisch, M. |c M.D. |4 oth | |
| 700 | 1 | |a Da Valle, M. |c M.D. |4 oth | |
| 700 | 1 | |a Demir, M. |c M.D. |4 oth | |
| 700 | 1 | |a Hoppensteadt, D.A. |c Ph.D. |4 oth | |
| 700 | 1 | |a Ahmad, S. |c Ph.D. |4 oth | |
| 700 | 1 | |a Walenga, J.M. |c Ph.D. |4 oth | |
| 700 | 1 | |a Fareed, J. |c Ph.D. |4 oth | |
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10.1111/j.0886-0440.2005.200316.x doi (DE-627)NLEJ243083971 DE-627 ger DE-627 rakwb Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization 350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . Blackwell Science Inc 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| Iqbal, O. M.D. oth Tobu, M. M.D. oth Aziz, S. M.D. oth Gerdisch, M. M.D. oth Da Valle, M. M.D. oth Demir, M. M.D. oth Hoppensteadt, D.A. Ph.D. oth Ahmad, S. Ph.D. oth Walenga, J.M. Ph.D. oth Fareed, J. Ph.D. oth In Journal of cardiac surgery Oxford : Wiley-Blackwell, 1986 20(2005), 1, Seite 0 Online-Ressource (DE-627)NLEJ243926588 (DE-600)2108425-7 1540-8191 nnns volume:20 year:2005 number:1 pages:0 http://dx.doi.org/10.1111/j.0886-0440.2005.200316.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 20 2005 1 0 |
| spelling |
10.1111/j.0886-0440.2005.200316.x doi (DE-627)NLEJ243083971 DE-627 ger DE-627 rakwb Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization 350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . Blackwell Science Inc 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| Iqbal, O. M.D. oth Tobu, M. M.D. oth Aziz, S. M.D. oth Gerdisch, M. M.D. oth Da Valle, M. M.D. oth Demir, M. M.D. oth Hoppensteadt, D.A. Ph.D. oth Ahmad, S. Ph.D. oth Walenga, J.M. Ph.D. oth Fareed, J. Ph.D. oth In Journal of cardiac surgery Oxford : Wiley-Blackwell, 1986 20(2005), 1, Seite 0 Online-Ressource (DE-627)NLEJ243926588 (DE-600)2108425-7 1540-8191 nnns volume:20 year:2005 number:1 pages:0 http://dx.doi.org/10.1111/j.0886-0440.2005.200316.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 20 2005 1 0 |
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10.1111/j.0886-0440.2005.200316.x doi (DE-627)NLEJ243083971 DE-627 ger DE-627 rakwb Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization 350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . Blackwell Science Inc 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| Iqbal, O. M.D. oth Tobu, M. M.D. oth Aziz, S. M.D. oth Gerdisch, M. M.D. oth Da Valle, M. M.D. oth Demir, M. M.D. oth Hoppensteadt, D.A. Ph.D. oth Ahmad, S. Ph.D. oth Walenga, J.M. Ph.D. oth Fareed, J. Ph.D. oth In Journal of cardiac surgery Oxford : Wiley-Blackwell, 1986 20(2005), 1, Seite 0 Online-Ressource (DE-627)NLEJ243926588 (DE-600)2108425-7 1540-8191 nnns volume:20 year:2005 number:1 pages:0 http://dx.doi.org/10.1111/j.0886-0440.2005.200316.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 20 2005 1 0 |
| allfieldsGer |
10.1111/j.0886-0440.2005.200316.x doi (DE-627)NLEJ243083971 DE-627 ger DE-627 rakwb Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization 350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . Blackwell Science Inc 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| Iqbal, O. M.D. oth Tobu, M. M.D. oth Aziz, S. M.D. oth Gerdisch, M. M.D. oth Da Valle, M. M.D. oth Demir, M. M.D. oth Hoppensteadt, D.A. Ph.D. oth Ahmad, S. Ph.D. oth Walenga, J.M. Ph.D. oth Fareed, J. Ph.D. oth In Journal of cardiac surgery Oxford : Wiley-Blackwell, 1986 20(2005), 1, Seite 0 Online-Ressource (DE-627)NLEJ243926588 (DE-600)2108425-7 1540-8191 nnns volume:20 year:2005 number:1 pages:0 http://dx.doi.org/10.1111/j.0886-0440.2005.200316.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 20 2005 1 0 |
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10.1111/j.0886-0440.2005.200316.x doi (DE-627)NLEJ243083971 DE-627 ger DE-627 rakwb Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization 350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England . Blackwell Science Inc 2005 Online-Ressource nicht spezifiziert zzz rdacontent nicht spezifiziert z rdamedia nicht spezifiziert zu rdacarrier Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. 2005 Blackwell Publishing Journal Backfiles 1879-2005 |2005|||||||||| Iqbal, O. M.D. oth Tobu, M. M.D. oth Aziz, S. M.D. oth Gerdisch, M. M.D. oth Da Valle, M. M.D. oth Demir, M. M.D. oth Hoppensteadt, D.A. Ph.D. oth Ahmad, S. Ph.D. oth Walenga, J.M. Ph.D. oth Fareed, J. Ph.D. oth In Journal of cardiac surgery Oxford : Wiley-Blackwell, 1986 20(2005), 1, Seite 0 Online-Ressource (DE-627)NLEJ243926588 (DE-600)2108425-7 1540-8191 nnns volume:20 year:2005 number:1 pages:0 http://dx.doi.org/10.1111/j.0886-0440.2005.200316.x text/html Verlag Deutschlandweit zugänglich Volltext GBV_USEFLAG_U ZDB-1-DJB GBV_NL_ARTICLE AR 20 2005 1 0 |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">NLEJ243083971</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230506005810.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">120427s2005 xx |||||o 00| ||und c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1111/j.0886-0440.2005.200316.x</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)NLEJ243083971</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rakwb</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="a">350 Main Street , Malden , MA 02148-5020 , USA and 9600 Garsington Road , Oxford OX4 2XG , England .</subfield><subfield code="b">Blackwell Science Inc</subfield><subfield code="c">2005</subfield></datafield><datafield tag="300" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">z</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zu</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. 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Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization |
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successful use of recombinant hirudin and its monitoring by ecarin clotting time in patients with heparin-induced thrombocytopenia undergoing off-pump coronary artery revascularization |
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Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization |
| abstract |
Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. |
| abstractGer |
Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. |
| abstract_unstemmed |
Abstract Refludan (lepirudin-rDNA for injection) is the first direct thrombin inhibitor approved by the United States FDA for anticoagulation to patients with heparin-induced thrombocytopenia (HIT). It was monitored by ecarin clotting time (ECT) assay in patients with HIT. Case histories and clotting parameters for three patients undergoing off-pump coronary artery revascularization procedure are discussed. The first patient received r-hirudin at a dose of 0.2 mg/kg intravenous (IV) bolus followed by 0.15 mg/kg/hour infusion. The second patient received 0.4 mg/kg IV bolus followed by infusion of 0.15 mg/kg/hour infusion. The third patient with renal failure received 0.2 mg/kg IV bolus followed by an infusion of 0.02 mg/kg/hour. Blood samples were drawn at baseline, 5 minutes post bolus and every 15 minutes during the coronary artery revascularization procedure. ECT was performed immediately on the citrated whole blood samples using the ECT cards in conjunction with the point-of-care, the thrombolytic assessment system (TAS) Analyzer (Pharmanetics, Raleigh, NC). The plasma samples were then analyzed for APTT and liquid ECT assay performed on a kinetic centrifugal analyzer (ACL 300 Plus). The ECT by cards was ideally maintained above 600 seconds during the surgical procedure. Additional boluses of Refludan were given as and when necessary (ECT < 600 sec) in order to maintain adequate anticoagulation. The calculated circulating concentrations of Refludan, following a bolus adminstration, based on the ECT cards, liquid ECT and APTT were 3.20 ± 1.3, 3.51 ± 1.35 and 2.02 ± 1.19 μg/mL, respectively. |
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Successful Use of Recombinant Hirudin and Its Monitoring by Ecarin Clotting Time in Patients with Heparin-Induced Thrombocytopenia Undergoing Off-Pump Coronary Artery Revascularization |
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