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Erschienen in: Pediatric Cardiology 4/2017

10.02.2017 | Original Article

Association Between Hematologic and Inflammatory Markers and 31 Thrombotic and Hemorrhagic Events in Berlin Heart Excor Patients

verfasst von: Amit Iyengar, Matthew L. Hung, Kian Asanad, Oh Jin Kwon, Nicholas J. Jackson, Brian L. Reemtsen, Myke D. Federman, Reshma M. Biniwale

Erschienen in: Pediatric Cardiology | Ausgabe 4/2017

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Abstract

Bleeding and thrombotic events remain a significant cause of morbidity in pediatric patients supported with ventricular assist devices (VADs). The objective of this study is to identify the association between markers of anticoagulation and bleeding and thrombosis events during Berlin Heart ExCor support. A retrospective, single-center analysis of 9 patients supported with the Berlin Heart ExCor was performed. Inflammatory and anticoagulation parameters including C-reactive protein, fibrinogen, partial thromboplastin time (PTT), and platelet count were measured at 48 and 24 h before and after bleeding or thrombosis events. Patients served as their own controls, and the same parameters were measured during a control period where subjects did not experience either event. All patients received the anticoagulation regimen proposed by Berlin Heart. A total of 31 bleeding or thrombotic events were identified and matched to 18 control events. Patient with predominantly thrombotic events tended to weigh less than those with bleeding events (Δ7.7 kg, p < 0.001). PTT levels were higher before and after bleeding (Δ17.36, p = 0.002) and thrombosis (Δ8.75, p < 0.001) events relative to control. Heparin dose decreased after a thrombosis event (Δ−5.67, p = 0.097), and this decrease was significantly different from control (p = 0.032). Non-collinearity between heparin dose and PTT should prompt further inflammatory and hematological investigation. In addition, heavier patients were more prone to bleeding complications. The role of inflammation in the development of thrombus or hemorrhages in the pediatric VAD population needs to be studied further.
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Metadaten
Titel
Association Between Hematologic and Inflammatory Markers and 31 Thrombotic and Hemorrhagic Events in Berlin Heart Excor Patients
verfasst von
Amit Iyengar
Matthew L. Hung
Kian Asanad
Oh Jin Kwon
Nicholas J. Jackson
Brian L. Reemtsen
Myke D. Federman
Reshma M. Biniwale
Publikationsdatum
10.02.2017
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 4/2017
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-017-1578-9

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