TEG<sup>®</sup> 6s Could Be Useful for Heparin Control in Pediatric Extracorporeal Membrane Oxygenation: A Case Report
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- Ogasawara Yuki
- Department of Clinical Engineering, Hokkaido Medical Center for Child Health and Rehabilitation Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation
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- Sakai Wataru
- Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation Department of Anesthesology, Sapporo Medical University of Medicine
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- Chaki Tomohiro
- Department of Anesthesology, Sapporo Medical University of Medicine
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- Mantoku Madoka
- Department of Clinical Engineering, Hokkaido Medical Center for Child Health and Rehabilitation Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation
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- Akai Kazunori
- Department of Clinical Engineering, Hokkaido Medical Center for Child Health and Rehabilitation Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation
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- Nawa Tomohiro
- Pediatric Cardiology, Hokkaido Medical Center for Child Health and Rehabilitation
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- Ichisaka Yuki
- Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation
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- Asai Hidetsugu
- Pediatric Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
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- Ebuoka Noriyoshi
- Pediatric Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
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- Oba Junichi
- Pediatric Intensive Care Unit, Hokkaido Medical Center for Child Health and Rehabilitation Pediatric Cardiovascular Surgery, Hokkaido Medical Center for Child Health and Rehabilitation
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- Yamakage Michiaki
- Department of Anesthesology, Sapporo Medical University of Medicine
Bibliographic Information
- Other Title
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- 小児ECMO中のヘパリンコントロールに対しTEG<sup>®</sup> 6sが有用であった1症例
Abstract
<p>Heparin doses are typically maintained at 180–200 s as activated clotting time (ACT) to assess anticoagulant therapy for venous arterial extracorporeal membrane oxygenation (V-A ECMO) in children. However, it is challenging to control the proper heparin dose during V-A ECMO with ACT clinically, which could result in fatal hemorrhagic complications such as cerebral hemorrhage. Although Viscoelastic hemostatic assay (VHA) device: TEG® 6s (Haemonetics Corp., Boston, USA) could be employed to determine the proper heparin dose during adult ECMO, there is no report about whether TEG® 6s could be effective for control of heparin therapy during ECMO in children. In our report, we discussed the clinical use of TEG® 6s for control of heparin therapy during ECMO in children. A 6-month-old female infant with a weight of 6.6 kg was scheduled to undergo an operation for supravalvular and coronary artery stenosis. Because heart failure worsened rapidly, V-A ECMO was needed for circulatory support. We observed that ACT and TEG® 6s revealed conflicting findings of heparin dose during ECMO. On the second hospital day, ACT was 130–150 s, which requested an increase in heparin. However, TEG® 6s demonstrated that the CK R-CKH R value was above the upper limit of measurement, which showed excessive heparin dose. We decided that heparin dose was reduced on the basis of TEG® 6s values. Eventually, V-A ECMO could have been used for 10 days without thrombotic, including intra-circuit thrombus and bleeding complications. Our report revealed the possibility that TEG® 6s might be better device to decide the proper heparin dose during ECMO in children than the ACT.</p>
Journal
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- Pediatric Cardiology and Cardiac Surgery
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Pediatric Cardiology and Cardiac Surgery 39 (1), 39-45, 2023-02-01
Japanese Society of Pediatric Cardiology and Cardiac Surgery
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Keywords
Details 詳細情報について
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- CRID
- 1390860631066432640
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- ISSN
- 21872988
- 09111794
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
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- Abstract License Flag
- Disallowed