The dosing and monitoring of argatroban for heparin-induced thrombocytopenia during extracorporeal membrane oxygenation: a word of caution.

Abstract:

:Heparin-induced thrombocytopenia is a serious complication of heparin use. Treatment includes discontinuation of heparin and initiation of alternative anticoagulation therapy. In extracorporeal membrane oxygenation anticoagulation is mandatory, and direct thrombin inhibitors (DTIs) have been approved in these cases. However, the use and monitoring of DTIs in extracorporeal membrane oxygenation patients is not well described. DTI use is also complicated by the imprecision of available monitoring tests and currently recommended dosing has been shown to result in a supratherapeutic anticoagulative state. This case report describes the successful use of the DTI argatroban as an alternative anticoagulant in a patient with heparin-induced thrombocytopenia requiring extracorporeal membrane oxygenation support.

journal_name

Anaesth Intensive Care

authors

Phillips MR,Khoury AI,Ashton RF,Cairns BA,Charles AG

doi

10.1177/0310057X1404200117

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

97-8

issue

1

eissn

0310-057X

issn

1448-0271

pii

20130550

journal_volume

42

pub_type

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