By International Anesthesia Research Society
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Extra resources for Anesthesia & Analgesia Vol 110 Issue 1 Jan 2010
Wei N, Klippel JH, Huston DP, Hall RP, Lawley TJ, Balow JE, Steinberg AD, Decker JL. Randomised trial of plasma exchange in mild systemic lupus erythematosus. Lancet 1983;1:17–22 30. Nadler S, Hidalgo J, Bloch T. Prediction of blood volume in normal human adults. Surgery 1962;51:224 –32 31. Lillo-Le Louet A, Boutouyrie P, Alhenc-Gelas M, Le Beller C, Gautier I, Aiach M, Lasne D. Diagnostic score for heparininduced thrombocytopenia after cardiopulmonary bypass. J Thromb Haemost 2004;2:1882– 8 32.
Heart rate response for each subject after IV injection of a test dose. All subjects had an increase in heart rate but 4 did not meet the 10% above baseline threshold set for a positive response. Data were analyzed with SAS for Windows (SAS Institute, Cary, NC). Heart rate changes were evaluated with a signed rank test. A quadratic regression of the heart rate over the 60-s window after test dose injection was performed. Arterial blood pressure data were evaluated by a sensitivity analysis using a binomial proportion to determine confidence limits and by signed rank test.
2). Anticoagulation was not required to treat HIT in any of this series of patients. Seven of 11 patients (64%) were not electively anticoagulated after the procedure. The remaining 4 patients were bridged to coumadin with IV bivalirudin because of placement of mechanical heart valves or VADs. Vol. 110, No. 1, January 2010 DISCUSSION We present a series of patients presenting for urgent, complex cardiac surgery with a recent diagnosis of HIT and a positive anti-HPF4 antibody screen. Patients were successfully managed with a strategy of intraoperative plasmapheresis, heparin reexposure during surgery, and daily monitoring of platelet counts.
Anesthesia & Analgesia Vol 110 Issue 1 Jan 2010 by International Anesthesia Research Society
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