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Off Target: Case Report of Heparin Resistance in a Neurosurgical Intensive Care Unit Patient.

Crit Care Nurse

June 2021

Sue Sirianni is the lead nurse practitioner in the surgical intensive care unit at Sinai-Grace Hospital, Detroit, Michigan, and an adjunct associate professor at Madonna University, Livonia, Michigan.

Introduction: Heparin resistance was discovered in a patient in the surgical intensive care unit who underwent emergency endovascular coiling and later an anterior communicating artery clipping procedure to treat subarachnoid hemorrhage due to rupture of an anterior communicating artery aneurysm.

Clinical Findings: On intensive care unit day 17/postoperative day 3, the patient experienced shortness of breath, persistent tachycardia, and hypoxia. Bilateral pulmonary emboli, a saddle embolus, and lower-extremity and upper-extremity deep vein thrombi were diagnosed.

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