Koroner Arter Bypass Greftleme Ameliyatı Sırasında Gelişen Heparin Direnci

Yıl 2015, Cilt: 7 Sayı: 1, 1 - 3, 01.04.2015

Tülay Örki Halide Oğuş Rezzan Yaltırık Atakan Erkılınç Füsun Güzelmeriç Deniz Avan Canan Güler Tuncer Koçak

Öz

In this paper we aimed to present a case and its treatment with the resistance of heparin before during cardiopulmonary bypass. 725.000 IU of heparin and 2 units of fresh frozen plasma were administered to patient undergoing coronary artery bypass graft surgery to reach required activated clotting time for secure aortic cannulation and cardiopulmonary bypass. Heparin resistance was considered to be improved depending on the previous heparin treatment. The effectiveness of heparin fulfilled with the treatment of fresh frozen plasma.

Anahtar Kelimeler

cardiopulmonary bypass, heparin resistance, activated clotting time, fresh frozen plasma

Development of Heparin Resistance During Coronary Artery Bypass Grafting Operation

Öz

Bu yazıda, kardiyopulmoner bypass sırasında karşılaşılan heparin direncine sahip bir olguyu ve tedavisini sunuyoruz. Koroner arter bypass greft cerrahisi planlanan hastaya güvenli aortik kanulasyon ve kardiyopulmoner bypass için gerekli olan aktive pıhtılaşma zamanına ulaşabilmek için 725.000 IU heparin ve 2 unite taze donmuş plazma verildi. Hastada önceki heparin tedavisine bağlı olarak heparin direnci gelişmiş olduğu düşünüldü. Taze donmuş plazma ile tedavi etmek heparinin etkinliğini yerine getirdi.

Anahtar Kelimeler

Kardiyopulmoner bypass, heparin direnci, aktive pıhtılaşma zamanı, taze donmuş plazma

Kaynakça

• Anderson JAM, Saenko EL. Heparin resistance. Br J Anaesth 2002; 88 ( 4) 67-69.
• Nicholson SC, Keeling DM, Sinclair ME, Evans RD. Heparin pretreatment does not alter heparin requirements during cardiopulnonary bypass. Br J Anaesth 2001; 87(6) 844-847.
• Esposito RA, Culliford AT, Colvin SB, Thomas SJ, Lackner H, Spencer FC. Heparin resistance during cardiopulnonary bypass. J Thorac Cardi- ovasc Surg 1983; 85: 346-353.
• Anderson EF. Heparin resistance prior to cardi- opulmonary bypass. Anesthesiology 5. 1986; 64(4) 504-507.
• Tuna N. Kardiyopulmoner bypass. In: Dönmez A, ed. Kalp Cerrahisinde Anestezi. Ankara: Güneş kitabevi 2002: 289-290.
• Staples MH, Dunton RF, Karlson KJ, Leonardi HK, Berger RL. Heparin resistance after preop- erative heparin therapy or intraaortic balloon pumping. Ann Thorac Surg 1994; 57(5) 1211- 1216.
• Dietrich W, Braun S, Spannagl M, Richter JA. Low preoperative antithrombin activity caus- es reduced response to heparin in adult but not in infant cardiac-surgical patients. Anesth Analg 2001; 92: 66-71.
• Dietrich W, Spannagl M, Schramm W, Vogt W, Barankay A, Richter JA. The influence of pre- operative anticoagulation on heparin response during cardiopulmonary bypass. J Thorac Car- diovasc Surg 1991; 102(4) 505-514.
• Cloyd GM, D’Ambra MN, Akins CW. Dimin- ished anticoagulant response to heparin in patients undergoing coronary artery bypass grafting. J Thorac Cardiovasc Surg 987; 94 (4) 535-538.
• Cilcan M E, AçıkgözA, Haberal İ. ve arkadaşları, Kardiyopulmoner Baypas Ameliyatlarında Hep- arinizasyon Güvenliği Açısından Taze Donmuş Plazmanın Etkinliği Var mıdır? GKDA Derg 2014;20 (2):85-90.
• Toprak Hİ, But AK, Borazan H ve ark., Heparin Direnci (Olgu sunumu),İnönü Ünv.Tıp Fak.Der- gisi 2003;10(2):91-93.