Key result
Argatroban achieves target systemic anticoagulation as a heparin alternative during ECLS.
Case Report (n=5)
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.
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Cornell et al. (2007) conducted a case report in Extracorporeal life support (ECLS) with suspected heparin-induced thrombocytopenia (n=5). Argatroban was evaluated on Achieve target systemic anticoagulation for activated clotting times between 210 and 230. Argatroban successfully achieved target systemic anticoagulation (activated clotting times 210-230) as an alternative to heparin in patients requiring ECLS.
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