Lepirudin Anticoagulation for Heparin‐Induced Thrombocytopenia After Cardiac Surgery in a Pediatric Patient

• Published in: Pharmacotherapy 2006-05, Vol.26 (5), p.709-712
• Main Authors: Knoderer, Chad A., Knoderer, Holly M., Turrentine, Mark W., Kumar, Manjusha
• Format: Article
• Language: English
• Subjects: Anticoagulants - adverse effects; Anticoagulants - therapeutic use; anticoagulation; Biological and medical sciences; Blood. Blood coagulation. Reticuloendothelial system; Cardiac Surgical Procedures; Child, Preschool; Echocardiography; Extracorporeal Membrane Oxygenation; Fontan Procedure; Heparin - adverse effects; heparin‐induced thrombocytopenia; Hirudins; HIT; Humans; Hypoplastic Left Heart Syndrome - complications; Hypoplastic Left Heart Syndrome - surgery; lepirudin; Male; Medical sciences; pediatric; Pharmacology. Drug treatments; Platelet Count; Postoperative Complications - drug therapy; Recombinant Proteins - therapeutic use; Thrombocytopenia - chemically induced; Thrombocytopenia - drug therapy
• ISSN: 0277-0008; 1875-9114
• DOI: 10.1592/phco.26.5.709

A 21‐month‐old boy received anticoagulation with lepirudin for heparin‐induced thrombocytopenia (HIT) after undergoing cardiac surgery and receiving extracorporeal membrane oxygenation (ECMO). This report illustrates the significance of HIT in pediatric patients after cardiac surgery and the successful administration of lepirudin in this setting. To our knowledge, this is the first published report of lepirudin administered to treat HIT in a child after cardiac surgery and ECMO. Although guidelines exist that suggest the potential administration of lepirudin as treatment for children with HIT, further studies are needed to determine the safest yet most effective dosage for this population.