Key result
Direct thrombin inhibitors, such as bivalirudin, are the recommended alternative anticoagulants for patients requiring cardiopulmonary bypass who cannot receive heparin.
Why the study?
What are the alternative anticoagulant options for patients requiring cardiopulmonary bypass who cannot receive heparin?
What are the alternative anticoagulant options for patients requiring cardiopulmonary bypass who cannot receive heparin?
Direct thrombin inhibitors such as bivalirudin are the recommended alternative anticoagulants for patients requiring cardiopulmonary bypass who have heparin-induced thrombocytopenia.
Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.
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Rehfeldt et al. (2016) conducted a review in Patients requiring cardiopulmonary bypass who cannot receive heparin (e.g., due to heparin-induced thrombocytopenia). Direct thrombin inhibitors (e.g., bivalirudin) was evaluated. Direct thrombin inhibitors, such as bivalirudin, are the recommended alternative anticoagulants for patients requiring cardiopulmonary bypass who cannot receive heparin.
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