The Use of Bivalirudin in Pediatric Cardiac Surgery and in the Interventional Cardiology Suite.
J Cardiothorac Vasc Anesth
; 34(8): 2215-2223, 2020 Aug.
Article
em En
| MEDLINE
| ID: mdl-32127273
ABSTRACT
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.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Cardiologia
/
Procedimentos Cirúrgicos Cardíacos
Limite:
Child
/
Humans
Idioma:
En
Revista:
J Cardiothorac Vasc Anesth
Assunto da revista:
ANESTESIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Moldávia