Monitoring Direct Thrombin Inhibitors: Time for Standardization

n=1; 54-year-old man with heparin-induced thrombocytopenia, unresponsive cardiogenic shock secondary to idiopathic cardiomyopathy, acute renal failure, and marked hepatic insufficiency presenting for insertion of a left ventricular assist device.

Bivalirudin (4.5 mg/kg total bolus and 5 mg/kg/h infusion) monitored with activated clotting time (ACT) targeting >400 s during cardiopulmonary bypass.

Postoperative hemorrhage and hemostasissafety