Abstract
Anticoagulation for extracorporeal life support (ECLS) is routinely achieved using heparin, which can be difficult in patients suspected of having heparin-induced thrombocytopenia. We describe a case series of five patients in which we used argatroban, a direct thrombin inhibitor, as an alternative to heparin for systemic anticoagulation during ECLS in patients suspected to have heparin-induced thrombocytopenia. Argatroban was used to achieve target systemic anticoagulation for activate clotting times between 210 and 230. Duration of argatroban use while on ECLS ranged from 6 to 184 hours. Argatroban dosage ranged from 0.2 to 3.5 microg/kg/min. Activated clotting times showed good agreement with aPTT. In conclusion, we illustrate that argatroban is a reasonable alternative to heparin anticoagulation for patients requiring ECLS.
MeSH terms
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Adult
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Aged
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Anticoagulants / administration & dosage
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Anticoagulants / adverse effects
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Anticoagulants / therapeutic use*
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Arginine / analogs & derivatives
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Cardiac Output, Low / complications
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Cardiac Output, Low / therapy
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Dose-Response Relationship, Drug
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Drug Administration Schedule
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Extracorporeal Circulation
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Female
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Heparin / adverse effects
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Humans
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Male
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Middle Aged
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Partial Thromboplastin Time
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Pipecolic Acids / administration & dosage
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Pipecolic Acids / therapeutic use*
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Respiratory Insufficiency / complications
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Respiratory Insufficiency / therapy
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Retrospective Studies
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Sulfonamides
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Thrombin / antagonists & inhibitors
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Thrombocytopenia / chemically induced
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Thrombocytopenia / complications
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Treatment Outcome
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Whole Blood Coagulation Time
Substances
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Anticoagulants
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Pipecolic Acids
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Sulfonamides
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Heparin
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Arginine
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Thrombin
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argatroban