肝素诱导的血小板缩症复杂化心脏性休克,需要持久的机械循环支持:一个病例报告
Peter Cangialosi1, Francine Dembitzer1, Anelechi C Anyanwu1
1Department of Medicine, Mount Sinai Hospital, 1 Gustave Levy Pl, New York, NY 10029, USA.
European heart journal. Case reports
|October 26, 2023
概括
在左心室辅助器件 (LVAD) 植入期间,对肝素诱导的血小板缩症 (HIT) 的管理具有挑战性. 血和IVIG成功降低了抗体,使得HIT患者的安全LVAD手术成为可能.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 氨酸诱导的血小板缩症 (HIT) 是对氨酸的严重免疫反应,在心脏手术过程中存在风险.
- 在左心室辅助器件 (LVAD) 植入过程中,手术内使用肝素因HIT而复杂化.
- 对于接受LVAD植入的HIT患者的管理数据有限.
研究的目的:
- 描述一个接受LVAD植入的HIT患者的成功外科治疗.
- 要突出使用等离子体和IVIG在缓解手术干预的HIT抗体的用途.
主要方法:
- 一名患有心脏性休克和HIT的52岁男性接受了LVAD植入.
- 治疗包括血酶和IVIG,以减少依赖肝素的血小板抗体.
- 在抗体减少后成功使用了手术内肝素.
主要成果:
- 在启动肝素治疗心脏性休克后,HIT得到证实.
- 血酶和IVIG导致肝素依赖的血小板抗体减少了60%.
- 成功实现了HeartMate 3 LVAD植入,患者在术后第17天出院.
结论:
- 使用IVIG进行等离子体合成可以成为管理HIT抗体的有效策略.
- 这种方法可能有助于在HIT患者中成功植入LVAD.
- 对于需要机械循环支持的HIT患者来说,仔细的术后管理至关重要.
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