Heparinoide als eine Alternative für die parenterale Antikoagulation bei Patienten mit Heparin-induzierter Thrombozytopenie

Zusammenfassung

Die Heparin-induzierte Thrombozytopenie (HIT Typ II) ist eine lebensbedrohliche Komplikation der Heparintherapie. Da betroffene Patienten durch diese immunologische, unerwünschte Wirkung der Heparingabe gefährdet sind, neue throm-boembolische Gefäßverschlüsse zu entwickeln, ist bei hinreichendem klinischen Verdacht die sofortige Umstellung auf ein kompatibles Antikoagulans notwendig. Hierfür kommen, neben rekombinantem Hirudin, verschiedene Heparinoide in Betracht. Die Pathophysiologie der HIT Typ II sowie die Struktur und die anti-koagulatorischen Eigenschaften verschiedener Heparinoide werden dargestellt. Der letzte Teil des Artikels faßt den gegenwärtigen Stand der Dosierungsempfehlungen für das Heparinoid Danaparoid (Orgaran®, NV Organon, Niederlande) bei HIT-Typ-Il-Patienten zusammen.

Schlüsselwörter

Heparin - Heparin-induzierte Thrombozytopenie - Thrombozyten - Danaparoid-Natrium - Heparinoide - Heparansulfat - Chondroitinsulfat - Therapie - Antikoagulanzien

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