Gravlee chapt 23 Flashcards
heparin binding relates directly to —?
MW and sulfation and is unrelated to ATIII affinity
Heparin induces platelet reaction characterized by release of? (4)
PF4
GPIIb/IIIa activation
P-selection expression
increased aggregation
Prime ECC with what amount of Heparin in units per ml
3U heparin per ml priming solution
thrombocytopenia
One common definition of thrombocytopenia is a platelet count below 50,000 per microlitre
Thrombocytosis
it can predispose to thrombosis in some patients
platelet count >700,000 per ml
ATIII affected persons usually have levels what % of normal
50% of normal
present with lower limb venous thrombosis
factors precipitating ATIII are (3)
pregnancy, infection, surgery
What explains the relative heparin resistance of newborn in comparison to adults?
they only have ATIII levels 60-80% of adults, yet don’s exhibit the thrombotic events that adults do at these levels.
Heparin administration in peds undergoing CPB should account for what?
account for large volumes of distribution, increased consumption and shorter elimination half life
Volume of ATIII or FFP needed to raise ATIII levels sufficiently in adult pts with ATIII deficiency to produce adequate anticoagulation are ?
1000 U ATIII
2-3 U of FFP
LMWH is a potent inhibitor of what?
Factor Xa
Danaparoid is a what?
- herparinoid
- anticoagulant
- alternative to heparin
- has been shown to have a lower cross-reactivity with HIT antibodies than LMWH
Ancrod
- defibrinogenating agent
- alt to heparin, anticoagulant
- lyses fibrinogen in a manner that precludes the formation of fibrin polymers
Hirudin unlike Heparin acts independently of what?
ATIII and inhibits clot-bound and fluid phase thrombin
Heparin alternative that is approved for HIT patients, pts w/unstable angina, thromboembolic stroke and appealing to patients with renal failure/insufficiency(but not dialysis patients)?
Argatroban (inhibits thrombin by binding to its catalytic site)
synthetic of arginine
