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001-es BibID:	BIBFORM061609
Első szerző:	Ferguson, Lee M.
Cím:	Recurring Extracorporeal Circuit Clotting During Continuous Renal Replacement Therapy in Fungal Sepsis / Ferguson, Lee M., Dreisbach, Albert W., Csongrádi, Éva, Juncos, Luis A., Fulop, Tibor
Dátum:	2013
ISSN:	0002-9629
Megjegyzések:	The relative effectiveness of anticoagulation strategies during continuous renal replacement therapy (CRRT) may vary according to the clinical circumstances. In this study, the case of a 46-year-old man who developed fungal mediastinitis with the pathogen Scedosporium prolificans after coronary bypass surgery is reported. Numerous debridements and multiple antifungal agents were not effective in this patient. Miltefosine, a non-Food and Drug Administration-approved agent, was started after institutional review board request and approval. CRRT was initiated with regional citrate anticoagulation (RCA) for clinical sepsis with acute kidney injury. Subsequently, crescendo clotting of the extracorporeal circuit (ECC) occurred. Multiple interventions, including escalating RCA, adding increasing heparin to RCA and exchanging the dialysis catheter, were not effective. Argatroban anticoagulation was started without further ECC clotting, and the patient recovered from both acute kidney injury and septic shock, despite continued miltefosine administration. Sepsis may contribute to recurrent ECC clotting. Argatroban, a direct thrombin inhibitor, had a disproportionate effectiveness to maintain ECC patency in this patient.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	American Journal Of The Medical Sciences. - 345 : 3 (2013), p. 256-258. -
További szerzők:	Dreisbach, Albert W. Csongrádi Éva (1969-) (szakorvos) Juncos, Luis A. Fülöp Tibor (1957-) (kardiológus)
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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