The Use of Bivalirudin in Pediatric Cardiac Surgery and in the Interventional Cardiology Suite.


Journal

Journal of cardiothoracic and vascular anesthesia
ISSN: 1532-8422
Titre abrégé: J Cardiothorac Vasc Anesth
Pays: United States
ID NLM: 9110208

Informations de publication

Date de publication:
Aug 2020
Historique:
received: 18 07 2019
revised: 07 01 2020
accepted: 10 01 2020
pubmed: 5 3 2020
medline: 28 4 2021
entrez: 5 3 2020
Statut: ppublish

Résumé

Anticoagulation is an essential component for patients undergoing cardiopulmonary bypass or extracorporeal membrane oxygenation and for those with ventricular assist devices. However, thrombosis and bleeding are common complications. Heparin continues to be the agent of choice for most patients, likely owing to practitioners' comfort and experience and the ease with which the drug's effects can be reversed. However, especially in pediatric cardiac surgery, there is increasing interest in using bivalirudin as the primary anticoagulant. This drug circumvents certain problems with heparin administration, such as heparin resistance and heparin-induced thrombocytopenia, but it comes with additional challenges. In this manuscript, the authors review the literature on the emerging role of bivalirudin in pediatric cardiac surgery, including its use with cardiopulmonary bypass surgery, extracorporeal membrane oxygenation, ventricular assist devices, and interventional cardiology. Moreover, they provide an overview of bivalirudin's pharmacodynamics and monitoring methods.

Identifiants

pubmed: 32127273
pii: S1053-0770(20)30081-1
doi: 10.1053/j.jvca.2020.01.020
pmc: PMC7321892
mid: NIHMS1552239
pii:
doi:

Substances chimiques

Anticoagulants 0
Hirudins 0
Peptide Fragments 0
Recombinant Proteins 0
Heparin 9005-49-6
bivalirudin TN9BEX005G

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

2215-2223

Subventions

Organisme : NHLBI NIH HHS
ID : K08 HL145132
Pays : United States

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

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Auteurs

Dheeraj Goswami (D)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.

Matthew DiGiusto (M)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University, School of Medicine, Baltimore, MD.

Rajeev Wadia (R)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.

Sean Barnes (S)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.

Jamie Schwartz (J)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.

Diana Steppan (D)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD.

Kristen Nelson-McMillan (K)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD; Department of Pediatrics, Johns Hopkins University, School of Medicine, Baltimore, MD.

Richard Ringel (R)

Department of Pediatrics, Johns Hopkins University, School of Medicine, Baltimore, MD.

Jochen Steppan (J)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, MD. Electronic address: J.Steppan@jhmi.edu.

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Classifications MeSH