@article{oai:kanazawa-u.repo.nii.ac.jp:00044906,
 author = {Kato, Hiroki and Yashiki, Noriyoshi and Iino, Kenji and Tomita, Shigeyuki and Watanabe, Go and 加藤, 寛城 and 矢鋪, 憲功 and 飯野, 賢治 and 富田, 重之 and 渡辺, 剛},
 issue = {3},
 journal = {日本心臓血管外科学会雑誌, Japanese Journal of Cardiovascular Surgery},
 month = {},
 note = {Anticoagulation management in cardiac surgery can be difficult in patients with heparin-induced thrombocytopenia (HIT). We report a patient who underwent reoperation of cardiopulmonary bypass (CPB) using argatroban in combination with nafamostat mesilate. A bolus of 0.25 mg/kg argatroban was administered, followed by continuous infusion of 5-10 μg/kg/min argatroban and 100 mg/h nafamostat mesilate. No complications such as thrombosis were observed during either CPB or the perioperative period. Although we used argatroban and nafamostat mesilate, which has a shorter half-life than argatroban, the anticoagulant effect was prolonged, and the patient had an uneventful postoperative course despite requiring substantial blood transfusion., へパリン起因性血小板減少症（HIT）を合併した症例に対する心臓手術のさいには，抗凝固管理が重要となる．今回我々はアルガトロバンとメシル酸ナファモスタットを併用した人工心肺下再手術を経験した．今回，アルガトロバンは0.25 mg/kgのbolus投与と5～10 μg/kg/minの持続投与，またメシル酸ナファモスタットは100 mg/hで使用した．人工心肺中や周術期に血栓症などの合併症は認めなかった．アルガトロバンとさらに半減期の短いメシル酸ナファモスタットを使用したにもかかわらず，抗凝固作用が遷延し多量の輸血を要することとなったが術後経過は良好であった．, 金沢大学医薬保健研究域医学系},
 pages = {112--114},
 title = {へパリン起因性血小板減少症を合併した僧帽弁位人工弁周囲逆流に対する再手術の1例},
 volume = {40},
 year = {2011}
}