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Original Article
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Korean J Med. 2008;74(1):254-259.
- 증례 : 저분자량 헤파린으로 혈액투석 중 발생한 출혈성 심장 눌림증 1예
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김소미, 유우주, 현진남, 김석영, 박상은, 이선미, 김나리
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- A case of hemorrhagic cardiac tamponade in a patient on low molecular weight heparin for hemodialysis
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So Mi Kim, Woo Joo Yoo, Jin Nam Heun, Sunk Yung Kim, San Hun Park, Sun Mi Lee, Na Ri Kim
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경희대학교 의과대학 순환기내과학교실
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- Abstract
- Low molecular weight heparin has some distinct advantages over unfractionated heparin. It is more bio-available, and laboratory monitoring is not necessary. Compared with unfractionated heparin, low molecular weight heparin does not result in an increased risk of major bleeding. However, bleeding tendency is not predictable in patients with renal failure, because low molecular weight heparin does not alter prothrombin times or partial thromboplastin times, making prediction of anticoagulation state impossible in these patients whose elimination of low molecular weight heparin is delayed. Recently, we treated a case of enoxaparin-associated hemorrhagic cardiac tamponade in a chronic dialysis patient. A 56-year-old man developed hemorrhagic cardiac tamponade during treatment with enoxaparin (40 mg). He experienced sudden dyspnea, mental status change, and hypotension. His vital signs were stabilized through cardiocentesis and conservative treatment. Low molecular weight heparin is a useful anticoagulant, but it may cause serious bleeding in hemodialysis patients.
Keywords :Hemorrhagic cardiac tamponade, Low molecular weight heparin, Hemodialysis
