Tirofiban'a Bağlı Diffüz Alveolar Hemoraji ECMO ile Tedavi Edilebilir mi?

Yıl 2019, Cilt: 14 Sayı: 1, 39 - 41, 15.03.2019

Murat Kerkütlüoğlu , Hakan Güneş Erdinç Eroğlu

https://doi.org/10.17517/ksutfd.442705

Öz

Akut koroner sendromların
gelişmesinde trombositler aktif rol oynar. Trombosit inaktivitesi için
kullanılan Glikoprotein (GP) IIb / IIIa inhibitörlerinin Perkütan Koroner
Girişim (PCI) sırasında kullanımı iskemik komplikasyonlardan korunmada kritik
öneme sahipken major kanamalarada yol açabilir. Diffüz alveoler kanama da,
glikoprotein IIb / IIIa inhibitörlerinin sebep olabileceği nadir ancak yaşamı
tehdit eden, tanı konması ve tedavisi güç bir komplikasyondur.Biz de olgumuzda
46 yaşında akut inferior miyokard infarktüsü nedeni ile primer PCI işlemi
yapılan ve tirofiban tedavisi sonrası diffüz alveolar hemoraji gelişen, ECMO
cihaz uygulaması ile tedavi etmeye çalıştığımız hastamızı sunuyoruz

Anahtar Kelimeler

tirofiban, diffüz alveolar hemoraji, ECMO

Is Diffuse Alveolar Haemorrhage due to Tirofiban Treated with ECMO?

Öz

Thrombocytes play an active role in
the development of acute coronary syndromes. The use of Glycoprotein (II) IIb /
IIIa inhibitors for platelet inactivity during Percutaneous Coronary
Intervention (PCI) may lead to major cancers with critical preservation of
ischemic complications. Diffuse alveolar hemorrhage is a rare but
life-threatening complication that can be caused by glycoprotein IIb / IIIa
inhibitors. We have a 46-year-old woman with acute inferior myocardial
infarction who underwent primary PCI and developed diffuse alveolar haemorrhage
after tirofiban therapy. We present the patient 
are trying to treat with ECMO device application.

Anahtar Kelimeler

tirofiban, diffuse alveolar hemorrhage, ecmo

Kaynakça

• 1.Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H,et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2017 Aug 26.
• 2. Conley M, Patino G, Romick B, Almaleh M, Campbell C, Hawkins K, et al. Abciximab-induced alveolar hemorrhage Texas Heart Institute Journal Diffuse Alveolar Hemorrhage 103 after percutaneous coronary intervention. Can J Cardiol 2008;24(2):149-51.
• 3.S.R Steinbuhl, J.D Talley, G.A Braden, et al.Point-of-care measured platelet inhibition correlates with a reduced risk of an adverse cardiac event after percutaneous coronary intervention: Results of the gold (au-assessing ultegra) multicenter study Circulation, 103 (2001), pp. 2572-257
• 4.S.M. Albelda, W.B. Gefter, D.M. Epstein, W.T. MillerDiffuse pulmonary hemorrhage: a review and classification Radiology, 154 (2) (1985), pp. 289-297
• 5 .Yilmaz MB, Akin Y, Biyikoglu SF, Guray U, Korkmaz S. Diffuse alveolar hemorrhage following administration of tirofiban in a patient with acute coronary syndrome: a fatal complication. Int J Cardiol 2004;93(1):81-2.
• 6 .Gill DS, Ng K, Ng KS. Massive pulmonary haemorrhage complicating the treatment of acute coronary syndrome. Heart 2004;90(3):e15.
• 7 .Fernandez-Perez GC, Vazquez M, Delgado C, Velasco M, Vazquez-Lima A, Rodriguez-Perez J. Pulmonary hemorrhage in a patient with acute coronary syndrome. AJR Am J Roentgenol 2007;189(3):W135-7.
• 8.Ener RA, Bruno N, Dadourian D, Wolf N, Van Decker W, Burke J, et al. Alveolar hemorrhage associated with platelet glycoprotein IIb/IIIa receptor inhibitors. J Invasive Cardiol 2006;18(6):254-61.
• 9 .Guo J, Xu M, Xi Y. Tirofiban-induced diffuse alveolar hemorrhage: after primary angioplasty. Tex Heart Inst J. 2012;39(1):99-103. Review.
• 10.Mosier J, Kelsey M, Raz Y, vd. Extracorporeal membrane oxygenation (ECMO) for critically ill adults in the emergency department: history, current applications, and future directions. Crit Care. 2015;19:431.